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Get CA cob017 - San Bernardino County 2013

ON FOR PEDDLER’S OR SOLICITOR’S BUSINESS LICENSE TYPE OF BUSINESS: Business Name: Telephone #: ( ) Address: Peddler Solicitor Type of Business: Alternate Telephone #: ( ) City: State: - PERSONAL INFORMATION: Name of Applicant: Last: Physical Address: Mailing Address: Contact Phone No: ( ) First: City: City: Driver’s License #: - Zip: Middle Initial: Zip: Zip: Date of Birth: ADDITIONAL APPLICANTS (others designated to peddle/solicit under applicant’s license): Use additional shee.

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