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Wrecker Permit Application <br />ear <br />Vehicle Infolrmation: <br />Motor/I.D. # <br />Vehicle to be Operated by: )3—us 1n6i Owner -or- <br />Vehicle is: ned ) -or- Rented <br />Page 2 of 3 <br />License # <br />bona fi�einploy <br />-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- NIA <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 any permit may <br />be revoked 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 III, Section 78-297, shall be cause for the <br />suspension of all permits hold by such corporation or partnership. <br />I hereb certify that all the statements contained in this application are true and correct to the best <br />of my fazowlo a. ' <br />x x - <br />In ' dual -Partner <br />x x <br />Corporation President attested by Corporation Secretary*** <br />***If Corporation, affix corporate seal to this application <br />SWORN AND SUBSCRIBED to before me, the undersigned authority, by the above <br />named person, this the 1%�'` day ofF�6i�c��" <br />No Public for th " Late of as <br />