APPLICATION FOR SOLICITATION-PEDDLER LICENSE
CITY OF PANORAMA VILLAGE, TEXAS
1. Full Name: __
2. Mailing Address: __
3. Permanent Residence Address: __
4. Cell phone: _________________________ Office phone: _____________________________
5. Date of Birth: ________________________ Place of Birth: ______________________________
6. Occupation for which applicant desires to obtain permit:
7. Give complete description of merchandise, etc. (including grade and character of property)to be
distributed or sold: __________________________________________________________________
__________________________________________________________________________________
8. Name of company employed by, if any: ___
Address: ___
Phone No: ______________________ Website: _______________________________________
Texas Sales License No. ________________________
9. Have you ever been convicted of a felony or a misdemeanor in the past 7 years? ___
If yes, list all criminal offenses: ___
______________________________________________________________________________
10. Are you a registered sex offender? ________________
11. Driver's License No. ____________________________
12. Motor vehicle’s make, model, and year: ______________________________________________
I HAVE READ AND AGREE TO COMPLY WITH THE TERMS AND CONDITIONS OF THE SOLICITATION
ORDINANCE FOR THE CITY OF PANORAMA VILLAGE.SUBJECT TO CRIMINAL PENALTIES, I HERERBY
DECLARE THAT THE ABOVE INFORMATION IS TRUE AND CORRECT.
WITNESS MY HAND AND SIGNATURE AT CITY OF PANORAMA VILLAGE, TEXAS, this the _____
day of __________________, 20_________.
____________________________________________
Signature of Applicant
City Witness: ___________________________ Date of Approval: ___________________________
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