CITY OF OAK PARK, MICHIGAN
DEALER IN PRECIOUS METALS, GEMS AND OTHER
PRECIOUS ITEMS APPLICATION
(Applications must be filed with the City Clerk not less than 30 days prior to the time a license is issued/renewed)
I HEREBY APPLY FOR A PRECIOUS METALS LICENSE IN ACCORDANCE WITH THE CODE OF ORDINANCES OF
THE CITY OF OAK PARK
New Renewal
Name of Applicant:
Applicant’s Address:
Applicant’s Driver’s License No:
Business Name: Phone No:
Business Address:
Email Address:
Nature of Business:
Number of Employees:
Hours of Operation:
Zoning Classification for this business location is:
I certify that this is the proper zoning to conduct this type of business.
Date taken:
DOB/Race/Sex:
Print of:
Right Thumb Left Thumb
Signature of Officer Taking Print
Indicate One:
Individual Partnership Corporation LLC (Limited Liability Company)
Check One:
Articles of Incorporation Attached Assumed Name Certificate Attached
Note: Separate application for each business location is required
I , under penalty of perjury, state that the above information is
(print name)
True, and that I have read the provisions of Act 95 of the Public Acts of 1981 and understand them, and that I
have informed my agents and employees, and will immediately inform all new agents and employees, of the
provisions of said Act. Further, under penalties of perjury I state, that neither I nor any of my agents or
employees have been convicted of a felony under Act No. 328 of the Public Acts of 1931, as amended, within
the five year period preceding the date of the application, or convicted of a misdemeanor under said laws
within a one (1) year period preceding the date of this application.
Signature of Applicant: __________________________________________ Date: ____________
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