Docstoc

Private Investigator License Application

Document Sample
Private Investigator License Application Powered By Docstoc
					         NAMPA CITY CLERK’S OFFICE
           411 THIRD STREET SOUTH
                NAMPA, ID 83651
                 (208) 468-5415
                  FAX 465-2314

                                CITY OF NAMPA
                   PRIVATE INVESTIGATOR LICENSE APPLICATION
 NON REFUNDABLE FEES:                                          ALL APPLICATIONS MUST BE
 LICENSE . . . . . . . . . . . . . . . $50.00                  ACCOMPANIED BY A $2,500.00
 BACKGROUND . . . . . . . . . $51.50                          SURETY BOND RUNNING TO THE
                                                            CITY OF NAMPA AND IN FULL FORCE
 TOTAL FEES DUE . . . . .. $101.50                          AND EFFECTIVE THROUGHOUT THE
                                                                    LICENSING PERIOD.




NAME __________________________________________________________________________________
                    First                                    Middle                                          Last

OTHER NAMES KNOWN BY (including Maiden) _______________________________________________

RESIDENCE ADDRESS ________________________________________________PHONE _____________
                                    Street                  City                   State    Zip

MAILING ADDRESS (if different from above) ___________________________________________________
                                                                          Street                      City          State   Zip

SOCIAL SECURITY NUMBER _______-_______-_______ DATE OF BIRTH ______________________

BUSINESS NAME EMPLOYED BY___________________________________________________________

BUSINESS ADDRESS ______________________________________________________________________
                                 Street                            City                       State                   Zip

List any outstanding warrants; been convicted, paid any fine, placed on probation, received a deferred sentence,
received a withheld judgment, or completed any sentence of confinement for any felony or misdemeanor
involving theft or dishonesty, within five (5) years prior to the date of making application.

     Date of Arrest                       Place of Arrest                          Charge                    Disposition




I do hereby authorize the City of Nampa, its agents and employees to seek information and conduct an
investigation into the truth of the statements set forth in my application and concerning my qualifications.
□   YES   □   NO


                                                COMPLETE REVERSE SIDE
I acknowledge by my signature below, I must maintain a bond as required by Nampa City Code 5-19-8. If said
bond is provided by my employer and I change employers during the effective period of my license, I
understand I am required to provide the Nampa Police Department with a new bond. Failure to maintain,
during the term of the license, all of the qualifications under which the license was issued, will be grounds for
revocation of license.

                                           STATEMENT OF OATH

I swear and affirm, under penalty of perjury pursuant to Title 18, Chapter 54 Idaho Code, that the statements
contained in the above application for a Patrol Agent/Alarm Installer are true and correct to the best of my
knowledge.



________________________________________________________________DATE _______________
APPLICANT SIGNATURE


State of Idaho   )

Canyon County )

On this _______________ day of __________________ in the year _______________, before me the
undersigned, a Notary Public, personally appeared ________________________________________ known or
identified to me to be the person whose name is subscribed within the instrument and acknowledge to me that
he/she executed the same.



______________________________________________
Notary Public
Residing at ______________________________________, Idaho
My Commission Expires: ___________________________



                                            For City Clerks Use Only


                     __________________________________            ______________________
                     Signature of Police Representative               Date


                    No Record Found
                    Record Found (see attached)


                    Approved
                    Disapproved

				
DOCUMENT INFO
Categories:
Tags:
Stats:
views:2
posted:11/13/2013
language:Unknown
pages:2
PermitDocsPrivate PermitDocsPrivate http://
About