INC. VILLAGE OF CEDARHURST 2008  Non-Resident Business Application for Parking Permit

Under Penalty of Perjury, the Undersigned Affirms as Follows:

NAME_______________________________________________________________

I RESIDE AT_________________________________________________________

MY TELEPHONE # IS_________________________________________________

BUSINESS PHONE # IS________________________________________________

Parking Permit will be used on the following vehicle:

MAKE________________ YEAR____________ PLATE #____________________

VEHICLE ID#________________________________________________________

It Is Understood That The Permit Is Void If Attached To Any Other Vehicle

PARKING PERMIT#____________________ DATE_______________________

   Sworn to me before this ________ Day                                       _____________________________
   of __________ 2008                                                                                   Name of Business

   _______________________________                                           ______________________________
   Notary Public                                                                                       Signature of Business Owner