Nps Form 10-550 - Commercial Use Authorization Application Page 5
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12NPS Form 10-550 (Rev. 11/2016)
OMB Control No. 1024-0268
National Park Service
Expiration Date: 11/15/2019
COMMERCIAL USE AUTHORIZATION APPLICATION
Voyageurs National Park
360 HWY 11 East
International Falls, Minnesota
56649
Ben Welch, CUA Coordinator
Phone Number: 218-283-6600
Some parks have additional requirements for businesses that offer services to visitors relating to the safety and welfare of the visitors
and protection of the resources. These requirements may include applicable operating licenses, certificates showing proof of training,
operating plans, emergency response plans, group size limitations, etc.
1.
Service for which you are applying: [See Attachment A for listing of available services.]
If “Yes”, list all parks and services provided.
2.
Will you be providing this service in more than one park? Yes
No
Applicant’s Legal Business Name: [Include any additional names (DBA) under which you will operate.]
3.
4.
Authorized Agents: (Name and title of owner, and any onsite person authorized to manage the operation or service, please
include licenses, certifications, and insurance information for each person listed.)
5.
Mailing Addresses
PRIMARY CONTACT INFORMATION (Dates to contact you at this address, if seasonal:
)
Address:
City, State, Zip:
Email:
Website:
Day Phone:
Evening Phone:
Fax:
ALTERNATE CONTACT INFORMATION (Dates to contact you at this address, if seasonal:
)
If same as “Primary Contact Information, check here
and go to question 6.
Address:
City, State, Zip:
Email:
Website:
Day Phone:
Evening Phone:
Fax:
6.
What is your Business Type? (Please check one below)
Sole Proprietor
Partnership (Print the names of each partner. If there are more than two partners, please attach a complete list of their
names.)
Name:
Name:
Corporation: (State:
Entity Number:
)
Non-Profit (Please attach a copy of your IRS Ruling or Determination Letter)
7.
State Business License Number:
Expiration Date:
Employer Identification Number (EIN): [This is not your Social Security Number. Please see #8 on page ‘i’ for explanation.]
8.
RECORDS RETENTION. TEMPORARY. Destroy/Delete 3 years after closure. (NPS Records Schedule, Commercial Visitor Services,
Page 1 of 8
(Item 5D) (N1-79-08-4))
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