Fillable PO Box 458 * Veneta, OR 97487 * (City of Veneta)

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PO Box 458 * Veneta, OR 97487 * (City of Veneta)

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File type: PDF

U.S.A. forms for City of Veneta

BROWSE CITY OF VENETA (OR) FORMS

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PO Box 458 * Veneta, OR 97487 * 541-935-2191 * Fax 541-935-1838 * www.venetaoregon.gov
Business Name:
Phone:
Street Address:
Mailing Address (required if different than street address – include zip code):
TYPE OF BUSINESS (PRODUCTS AND/OR SERVICE PROVIDED)
Information for vehicle used for this business (use supplemental form if more than two vehicle(s) are
being used)
ATTACH PROOF OF INSURANCE FOR EACH VEHICLE
#1
Year:
Make:
Model:
Color:
Driver’s License Number & State:
Policy Number:
# 2
Year:
Make:
Model:
Color:
Driver’s License Number & State:
Policy Number:
Complete information for all employees soliciting for this Business (use supplemental form if more
than two solicitors will be conducting business within the City limits of Veneta)
PHOTO IDENTIFICATION IS REQUIRED
#1 Check the applicable box: [ ] Owner [ ] Employee
Name: ___________________________________________ Date of Birth: __________________
Address: ________________________________________________________________________
Phone: ( ) __________________ Cell Phone: ( ) __________________
#2 Check the applicable box: [ ] Owner [ ] Employee
Name: ___________________________________________ Date of Birth: __________________
Address: ________________________________________________________________________
Phone: ( ) __________________ Cell Phone: ( ) __________________
Itinerant Business Application
Resolution No. 1033
Location where goods or property proposed to be sold are manufactured or produced (be specific):
Street Address where goods or property proposed to be sold are currently located:
Proposed method goods or property sold will be delivered:
By signing this application, the applicant is acknowledging and agreeing to the following:
I understand all owners/employees of this business must keep a copy the business registration
on their person.
This business is in compliance with all local, county, state, and federal laws.
I understand this business is limited to operating between the hours of 9:00 a.m. and 7:00 p.m.
I understand I am prohibited from entering upon private property that has been posted “no
trespassing” or “no soliciting”.
I understand I am prohibited from continuing to solicit to a person who has declined a request.
I understand I may not obstruct traffic along any sidewalk, bike path, or street unless written
approval is granted by the City.
I understand this business registration in non-transferable.
Name of Applicant:
Signature of Applicant: Date:
Number of
Employees
Fee based on
Employees
$50.00 for 1
st
2
$5.00 for ea.
Additional
Receipt
Number
Date Issued
Expiration Date
See Resolution No. 1033 for any Additional Information
Itinerant Business Application – Additional Employees
Name of Business:
Photo ID is required for all employees listed below
#3 Check the applicable box: [ ] Owner [ ] Employee
Name: ___________________________________________ Date of Birth: __________________
Address: ________________________________________________________________________
Phone: ( ) _________________ Cell Phone: ( ) _________________
#4 Check the applicable box: [ ] Owner [ ] Employee
Name: ___________________________________________ Date of Birth: __________________
Address: ________________________________________________________________________
Phone: ( ) __________________ Cell Phone: ( ) _________________
#5 Check the applicable box: [ ] Owner [ ] Employee
Name: ___________________________________________ Date of Birth: __________________
Address: ________________________________________________________________________
Phone: ( ) __________________ Cell Phone: ( ) ________________
#6 Check the applicable box: [ ] Owner [ ] Employee
Name: ___________________________________________ Date of Birth: __________________
Address: ________________________________________________________________________
Phone: ( ) __________________ Cell Phone: ( ) ________________
#7 Check the applicable box: [ ] Owner [ ] Employee
Name: ___________________________________________ Date of Birth: __________________
Address: ________________________________________________________________________
Phone: ( ) __________________ Cell Phone: ( ) ________________
#8 Check the applicable box: [ ] Owner [ ] Employee
Name: ___________________________________________ Date of Birth: __________________
Address: ________________________________________________________________________
Phone: ( ) __________________ Cell Phone: ( ) ________________
Name of Business:
Proof of Insurance is REQUIRED for all vehicles listed below:
#3
Year:
Make:
Model:
Color:
Driver’s License Number & State:
Policy Number:
#4
Year:
Make:
Model:
Color:
Driver’s License Number & State:
Policy Number:
#5
Year:
Make:
Model:
Color:
Driver’s License Number & State:
Policy Number:
#6
Year:
Make:
Model:
Color:
Driver’s License Number & State:
Policy Number:
#7
Year:
Make:
Model:
Color:
Driver’s License Number & State:
Policy Number:
#8
Year:
Make:
Model:
Color:
Driver’s License Number & State:
Policy Number:
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PO Box 458 * Veneta, OR 97487 * (City of Veneta)

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Completed 17 July 2020

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