Form - Ar-1r-Ven - Merchandise Vending Registration Supplement
Download a blank fillable Form - Ar-1r-Ven - Merchandise Vending Registration Supplement in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form - Ar-1r-Ven - Merchandise Vending Registration Supplement with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2ARKANSAS DEPARTMENT OF FINANCE AND ADMINISTRATION
Merchandise Vending Registration Supplement Form - AR-1R-VEN
SECTION A: OWNERSHIP INFORMATION
Legal Name (Enter full legal name of business):
OR
Federal Identification Number (FEIN):
-
Social Security Number (SSN):
-
-
SECTION B: OPTION AND DECAL SELECTION
Options:
Decal Qty Requested
Option 1
Option 2
Option 3 (Request decal type(s) below)
Option 3 (if purchasing before January 1)
Decal Qty Requested
Rate
Amount Due
Type A: $0.25 or more (electronically operated)
$93.00
Type B: Less than $0.25 (electronically operated)
$15.00
Type C: Bulk, greater than $0.25 (manually or electronically operated)
$7.50
Type D: Bulk, $0.25 or less (manually or electronically operated)
$2.50
Type E: $0.25 or more (manually operated)
$30.00
Option 3 (if purchasing after January 1)
Decal Qty Requested
Rate
Amount Due
Type A: $0.25 or more (electronically operated)
$46.50
Type B: Less than $0.25 (electronically operated)
$7.50
Type C: Bulk, greater than $0.25 (manually or electronically operated)
$3.75
Type D: Bulk, $0.25 or less (manually or electronically operated)
$1.25
Type E: $0.25 or more (manually operated)
$15.00
Option 3 (Special Event)
30 Day Periods*
Decal Qty Requested
Rate
Amount Due
Type A: $0.25 or more (electronically operated)
$18.60
Type B: Less than $0.25 (electronically operated)
$3.00
Type C: Bulk, greater than $0.25 (manually or electronically
$1.50
operated)
Type D: Bulk, $0.25 or less (manually or electronically operated)
$0.50
Type E: $0.25 or more (manually operated)
$6.00
Total Amount Due:
*Special Event permits are issued in 30 days increments.
(Print Name)
(Signature of Requestor)
Date
Page 1 of 2
Merchandise Vending Registration Supplement Form - AR-1R-VEN (R 10/31/12)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial