Gresham%20Second-Hand%20or%20Precious%20Metal%20and%20Gem%20Dealer%20License by PermitDocsPrivate

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									                 City of Gresham                                    1333 NW Eastman Parkway
                 Business License Section                           Gresham, OR 97030-3813
                                                                    (503) 618-2370

                                         Second Hand Dealer
                                        Precious Metal & Gem
                                             Application
Second Hand Dealer:
Any person engaged in, conducting, managing or carrying on a business that purchases or sells any items that
have been purchased or sold as used goods shall be required to obtain a Second Hand Dealer Permit.
                                                                                     (Gresham Code 9.05.020)
Precious Metal & Gem Dealer:
Any person engaged in, conducting, managing or carrying on a business for the purpose of purchasing precious
metals or gems from any person not representing a bona fide, licensed business is required to obtain a Precious
Metal & Gem Dealer Permit.                                                           (Gresham Code 9.05.020)

The “purchase” of any property regulated by this code includes consignment of property for sale or trade of
property except as trade-ins as part of the purchase of a new article of property.


 Please complete the following application. The application fee is $25.00.

1. To Be Issued To:

                                   Name of owner, Partners or Corporation

    __ Individual Proprietorship                   __ Partnership                  __ Corporation

2. Business Name:                 ______________________________________________________

3. Location Address:              ______________________________________________________

4. Mailing Address:               ______________________________________________________

5. City, State, Zip:              ______________________________________________________

6. Phone:                         _______________________________

7. Business License No: _______________________________

8. Description of exact nature of business to be operated:




    Hours of Operation:           Weekdays: Open __________                 Close __________
                                  Weekends: Open __________                 Close __________
9. Owner / Partnership / Corporation:
   Please complete the following for each owner and partner of the business, and
   for all those holding 5% or more of stock in the applicant corporation.

  Name
  Title
  Address
  City, State, Zip
  Occupation
  Telephone                                  No. Of Shares
  Date of Birth                              General, Limited
                                             or Silent Partner


  Name
  Title
  Address
  City, State, Zip
  Occupation
  Telephone                                  No. Of Shares
  Date of Birth                              General, Limited
                                             or Silent Partner


  Name
  Title
  Address
  City, State, Zip
  Occupation
  Telephone                                  No. Of Shares
  Date of Birth                              General, Limited
                                             or Silent Partner


  Name
  Title
  Address
  City, State, Zip
  Occupation
  Telephone                                  No. Of Shares
  Date of Birth                              General, Limited
                                             or Silent Partner
  Name
  Title
  Address
  City, State, Zip
  Occupation
  Telephone                                    No. Of Shares
  Date of Birth                                General, Limited
                                               or Silent Partner


10. Corporation:
    Date and State of Incorporation:   __________________________________________

11. List any criminal arrests or convictions for any theft or fraud activities for any
    individuals listed on this application.




12. Have you ever had a Precious Metal & Gem or Second Hand Dealer’s permit
    refused, suspended or revoked in this or any other city or state?
                       Yes______       No______
    If yes, state type of permit, date(s), location(s), and reason for refusal,
    suspension or revocation.




13. If you had a Precious Metal & Gem or Second Hand Dealer ‘s permit refused,
    suspended or revoked, list your subsequent business activity or occupation.




14. Give detailed description of your previous Precious Metal & Gem or Second
    Hand Dealer activities in this or any city with a similar permit.
Personal History Application
This application must be accompanied by a Personal History Application form for
each person named in section #9 above. Completion of these application forms and
submission with the non-refundable fee as provided by code does not imply any
commitment on the part of the City of Gresham to grant the requested permit
except as required by code.

Corporation Certificate / Articles of Incorporation
Please include a copy of the Corporation Certificate and/or Articles of Incorporation
with this application.


Issuance of a City of Gresham regulatory permit does not relieve the permittee from
the obligation to meet all other applicable federal, state and local laws and
regulations.

The undersigned hereby states that the statements made in this application are
true and correct to the best of his/her knowledge and belief and that this statement
is executed with the knowledge that any false statement, misrepresentation, or
failure to reveal information requested may be deemed sufficient cause for refusal
to issue, for suspension or for revocation of a regulatory permit.




Signature

________________________________________________
Title

________________________________________________
Date

								
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