INC. VILLAGE OF CEDARHURST 2008 Non-Resident 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_______________________

SIGNATURE________________________________________________________