Solicitor's Permit Application - New Albany, Ohio

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Vehicles Used in Solicitation: Make: Color: Model: License Plate Number: Year: State: Make: Color: Model: License Plate Number: Year: State: Make: Color: Model: License Plate Number: Year: State: Make: Color: Model: License Plate Number: Year: State: Make: Color: Model: License Plate Number: Year: State: Police Department Use Only Company / Solicitor Findings AG Record: BBB Rating: Individual Solicitor Records Checked: Additional Notes: Police Clerk: Chief of Police: Approved by Chief of Police: Recommendation: Date: Yes No PD-08-143 Revised May 23, 2012 2
Fulll Name: Complete Address: Individual Solicitor’s Information (to be completed by individual solicitor) Phone: SSN: DOB: Race: Height: Weight: Eye: Hair: Length of employment with company: List all employment within the past year (company name, city and state): List all residences within the past year (address, city, state and zip): City List any arrests, other than traffic violations: State Charge Name Phone References: Address Have you applied for a <strong>New</strong> <strong>Albany</strong> Solicitors permit before? If yes, when? Do you hold a valid driver’s license? If yes, what state and OL number Yes Yes No No 11a Check FC County Additional Information Police Department Usee Only Individual Solicitor Findings: PD-08-143 Revised May 23, 2012 3
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Solicitor's Permit Application - New Albany, Ohio

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