Solicitor Permit Application Townsend By-Laws – Solicitors Name*Date of Birth* Date Format: MM slash DD slash YYYY Home/Cell PhoneWork PhoneEmail* Employer*Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Permit Request - Start Date* Date Format: MM slash DD slash YYYY Permit Request - End Date* Date Format: MM slash DD slash YYYY *Permit duration not to exceed 12-months.Type of Business/Goods/Services*Vehicle Year*Vehicle Make*Vehicle Model*Vehicle Color*Vehicle Plate Number/State*Have you been convicted of any crime or misdemeanor within ten years of date of application, except violations of motor vehicle laws?* Yes No If yes, please list the nature of the offense(s): A fee of $25 per person for each permit (check or money order payable to Townsend Police Department). A copy of your driver’s license and registration of vehicle used. The permit is to be on your person at all times while soliciting in Townsend, accessible if asked. All persons soliciting door-to-door require a permit. Door-to-door solicitation is permitted from 9:00 AM to 7:00 PM only, not including Sundays and holidays. Violation of Townsend By-Law is punishable by suspension or revocation if regulations and laws are not followed. Any person violating the By-Law shall, upon conviction in a court of law, be punished by a fine not to exceed $50. Consent I agree to the requirements.By agreeing and submitting this application indicates that I have read and understand the above requirements and that I will abide by the Town of Townsend By-Law regarding solicitation. I understand that this application is subject to a background check and approval by the Chief of Police and that once issued, it may be suspended or revoked if regulations and laws are not followed.