Fillable Residential Solicitation Application (Page 4 of 4) in pdf

Please provide two photographs suitable for reproduction, measuring at least 1.5 inch x 1.5 inch and

showing the head and shoulders of the proposed solicitor in a clear and distinguishing manner, which

shall have been taken within the preceding 60 days before filing the application.

Please provide proof of possession of any license or permit which is required by the city in order to

conduct the proposed solicitation.

Please provide appropriate written credentials that authorize the solicitor to solicit on the master solicitor’s

behalf.

Please describe the nature of solicitation activity:

___________________________________________________________________________________

__________________________________________________________________________________.

Please state the approximate time period when the soliciting will be conducted, including the projected

start date: ___-___-___ and the completion date: ___-___-___, and the proposed days of the week:

____________________________________ and times of day _____________________________ of

the solicitation.

10.

In the case of residential selling, please describe the method of payment for the goods or services:

___________________________________________________________________________________

__________________________________________________________________________________.

11.

If the proposed solicitor has a manager that is or will be present in the city during all or any portion of the

solicitation, please provide the name, permanent and, if applicable, local business address (not a post

office box), and complete contact information of the manager:

Permanent address:

________________________________________________________

Telephone: _______________ Facsimile: __________________ E-Mail: _________________

Local address:

________________________________________________________

Telephone: _______________ Facsimile: __________________ E-Mail: _________________

The undersigned hereby swears or affirms that the information contained in this application is true and

correct.

Signature:

_____________________________________

Type or print name:

_____________________________________

Title:

_____________________________________

Sworn to and subscribed before me this the _____ day of ___________________, 2012.

_________________________________________

Notary Public

My commission expires: ____________________

Residential Solicitation Application Page 4