Fillable Applicant Information 5171 Northwest Parkway, Hilliard, OH 43026 (City of Hilliard)

Fill Online, Printable, Fillable, Blank Applicant Information 5171 Northwest Parkway, Hilliard, OH 43026 (City of Hilliard) Form

Use Fill to complete blank online CITY OF HILLIARD (OH) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Applicant Information 5171 Northwest Parkway, Hilliard, OH 43026 (City of Hilliard)

On average this form takes 18 minutes to complete

The Applicant Information 5171 Northwest Parkway, Hilliard, OH 43026 (City of Hilliard) form is 2 pages long and contains:

  • 0 signatures
  • 0 check-boxes
  • 73 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Hilliard

BROWSE CITY OF HILLIARD (OH) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
HPD-090 (Rev. 09-18) Pg. 1 of 2
Applicant Information
First Name:
Middle Name:
Last Name:
Email:
Cell:
Social Security #:
Date of Birth:
Height:
Weight:
Eye Color:
Home Address:
City:
Zip:
Temporary Address:
City:
Zip
List any community where you have conducted peddling or solicitation activities within the past 6 months:
List all criminal convictions other than minor traffic within the past five (5) years:
All Additional Places of Residence for Applicant in the Past 12 Months
Street Address:
City:
State:
Zip:
Street Address:
City:
State:
Zip:
Street Address:
City:
State:
Zip:
Street Address:
City:
State:
Zip:
Street Address:
City:
State:
Zip:
Company Information
Corporate/Business or dba Name:
Address:
City:
State:
Zip:
Business Phone:
Supervisor’s Name:
Supervisor’s Phone:
Length of Time Employed By Company:
Type of Business/ Description of Merchandise/Product for Sale/Services Furnished:
Vehicle Information
Color:
Year:
Make:
Model:
License Number:
State in Which Vehicle is Registered:
TRANSIENT VENDOR APPLICATION
Hilliard Division of Police
5171 Northwest Parkway, Hilliard, OH 43026
Phone: 614.876.2429 Email: hilliardpolice@hilliardohio.gov
How Long at This Address?
CLEAR FORM
HPD-090 (Rev. 09-18) Pg. 2 of 2
All Additional Employment for Applicant in the Past 12 Months
Business Name:
Street Address:
City:
State:
Zip:
Business Name:
Street Address:
City:
State:
Zip:
Business Name:
Street Address:
City:
State:
Zip:
Required Documents & Fee
$50.00 Non-refundable Application Fee (No cash or credit cards accepted.)
______Check (Payable to City of Hilliard) ______Money Order
Show valid driver’s license or government issued identification. If applicant is not a U.S. citizen, show valid
passport from country of origin and proof of legal entrance into the U.S. and authorization to work.
Provide, in its entirety, a copy of recent Ohio Bureau of Criminal Investigation (BCI) or Federal Bureau of
Investigation (FBI) background results. Any WebCheck location can submit your fingerprints to BCI/FBI;
however, as a courtesy, we have provided the information for two local companies. Request that the
WebCheck processor send the BCI/FBI results directly to you, NOT the City of Hilliard.
• Northwest Kiwanis Deputy Register, 4740 Cemetery Road, Hilliard, Ohio 43026. Ph: 614.529.1203
• Biometric Information Management, 6059 Frantz Rd, Ste 102, Dublin, Ohio 43017. Ph: 614.456.1296
Photo Taken On-site
Once you have all required documents, call Linda Haynes at 614.334.2140 to schedule an appointment to
provide your required documents and have your photo taken.
Certification
I certify that all information provided on this application is correct. I certify that any criminal history I have has
been included with this application. I understand that any falsification will result in revocation of the permit.
I certify that, if granted a permit, I will not use the permit as an endorsement by the City, a city department or city
employee of my company or products or services peddled/solicited.
I certify that I have been given a copy of Chapter 745 of the City of Hilliard Codified Ordinances.
I certify that, if granted a permit, I will maintain compliance with Chapter 745 of the City of Hilliard Codified
Ordinances and all applicable county and state statutes, rules and regulations that affect transient vendors.
Applicant Signature: ______________________________________________________ Date: ________________________________
For Administrative Use Only
Approved?
Yes
No
Remarks:
Photo ID License Printed Notified for Pickup
Reviewed By:
Receipt #:
Permit #:
Permit Dates:
From:
To:
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Applicant Information 5171 Northwest Parkway, Hilliard, OH 43026 (City of Hilliard)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 3 August 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document