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Wmcker Permit Application <br />Vehicle Information: <br />Pago 2 of 3 <br />165 r1otA F""�� <br />Year Make/Model Motor/I.D: # License # <br />Vehicle to be Operated by: Business Owner -or- bona fide emplo e <br />Vehicle : wne -or- Rented -or- Leased <br />NOTE: If not owned by applicant; a copy of.the vehicle rental or lease agreement must be provided. <br />Agreement Provided: Yes -or- !A <br />I hereby agree to obey the provisions of the City's rules and regulations, ordinances and statutes <br />applicable to motor vehicles and understand that upon my failure to so obey such laws that my permit may <br />be revolted or suspended without notice. <br />I understand that all changes of officers or partners shall be reported to the City Secretary within <br />ten. (10) days after the change, and such new officers or partners shall individually file applications <br />certifying to their individual qualifications within such time. The failure to certify within such time or to <br />possess such qualifications required of such persons under Article M, Section 78 297, shall be cause for the <br />suspension of all permits held by such corporation or partnership. <br />I hereby certify that all the statements contained in this application are true and correct to the best <br />of my knowl e. <br />X X <br />dividual Partner <br />X <br />Corporation President attested by Corporation Secretary*** <br />***If Corporation, affix corporate seal to this application <br />SWORN AND SUBSCREB to before me, the undersi ed authority, by the above <br />named person, this the ay of <br />No Public for the S to of T as <br />G. RAMIREZ <br />R6:c, Sera d Tnas <br />SEPTEAI R F,�n <br />' V. 2013 <br />