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2. Handbill Permit Application
4. Applicant
6. Name*
7. Phone Number*
8. Email Address*
10. Address*
11. City*
12. State*
13. Zip Code*
17. Distributor
    If an assume name is used, please include true names and addresses of owners, manager or agents of persons sponsoring said handbill.
19. Name of Business or Organization*
21. Contact Name*
22. Phone Number*
23. Email Address*
25. Address*
26. City*
27. State*
28. Zip Code*
30. Contact Name
31. Phone Number
32. Email Address
34. Address
35. City
36. State
37. Zip Code
41. Manufacturer
43. Name*
44. Phone Number*
45. Email Address*
47. Address*
48. City*
49. State*
50. Zip Code*
54. Description of matter to be distributed. *
    Please also upload a copy of what will be distributed.
56. Dates of distribution*
    Dates of distribution Start Date

    Dates of distribution Start Time

    —

    Dates of distribution End Date

    Dates of distribution End Time
58. Location to be circulated*
59. Number of agents distributing materials *
61. License Fee:
    $30.00/ one year from date approved.
62. Note:
    All material distributed must contain names and addresses of the manufacturer and the distributor on the cover, front or back, thereof.
64. Exemptions:
    The provisions of this ordinance shall not be deemed to apply to the distribution of mail by the United States, nor to newspapers as defined in this ordinance. Any person who shall violate any provision of this ordinance, upon conviction thereof, shall be punished by a fine or penalty of not more than $100.00, or be imprisonment, for not exceeding 90 days, or both such fine or imprisonment.
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66. Submit

* indicates a required field