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2. 
6. Name
8. Phone Number
9. Date of Birth
11. Height
12. Weight
13. Sex
15. Hair Color
16. Eye Color
18. Driver's License Number
20. Vehicle Description
22. Make
23. Model
24. Color
26. Name of Company Being Represented
28. Company Address
30. Company Phone Number
31. Type of Service
33. Permit Fee

    $100.00

34. Copy of Driver's License
36. ***************PERMIT EXPIRES 60 DAYS FROM DATE OF ISSUANCE****************
38. ********************************HOURS OF OPERATION********************************
40. SOLICITOR/PEDDLER : 10 AM TO 6 PM (CST)- NO SUNDAY
42. SOLICITOR/PEDDLER : 10 AM TO 5 PM (DST) - NO SUNDAY
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44. 1. Receive an email copy of this form.
45. Email address

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46. Submit

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