OFFICE OF THE TOWN CLERK
KATE MURRAY
Town Clerk
One Washington Street Hempstead, NY 11550
Tel: (516) 812-3025 email: licensing@tohmail.org
DONALD X. CLAVIN JR.
Supervisor
AUCTION SALES
Name:
D.B.A:
Address:
Phone #:
Email address:
Date auction is to be held:
Type of merchandise to be auctioned:
T.O.H. auctioneer License #:
End date: Total number of days:
Sworn to before me this
Day of
20
NOTARY PUBLIC
Signature of Applicant
Rev. 1/20
Office Use Only
LICENSE #
FEE PAID
DATE