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Westminster Security Company Permit Application

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Westminster Security Company Permit Application Powered By Docstoc
					                                                           WESTMINSTER POLICE DEPARTMENT
                                                        SECURITY COMPANY PERMIT APPLICATION
Name of Security Company                                                                                                                            Telephone



Street Address                                                       City                                                                           Zip



Owner                                                                                                                                               Telephone



Home Address                                                         City                                                                           Zip



Sex     Hair       Eyes      Height         Weight          Date of Birth                           Social Security Number                          Driver's License



Co-Owner                                                                                                                                            Telephone


Home Address                                                         City                                                                           Zip



Sex     Hair       Eyes      Height         Weight          Date of Birth                           Social Security Number                          Driver's License



Names of Security Officers




Description of company's method of operation




List any arrests and/or convictions of any violation of law, including vehicle cites/fines over $15.00




Any false, misleading or fraudulent statement, whether knowingly or negligently made in connection with this application or in any document required by
the Chief of Police, will result in denial or revocation of permit. Permit is not transferable to another person. Filing of an application and payment of fees
does not allow applicant to work. The receipt is not a work permit.


Signature                                                                                                                    Date
                      Please attach the following document:                 Listing of patrol guards working for company
                                                                            Map of district, territory or area proposed to be served by patrol system

OFFICIAL USE ONLY                                                                                                                                                   Map of
                                                                                                                                              Company               area to be
File Fee $                                     Receipt No.                                     Received by:                                   Letter                patrolled

Approved                                                                                                    Denied
                           Chief of Police (or designee)                                                                            Chief of Police (or designee)
Effective                                          Expiration                                                                                 Date
Date                                               Date                                                  Permit No.                           Issued
WPD #450 (10/04)

				
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