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FORM BUS BUSINESS PARKING PERMIT

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FORM BUS BUSINESS PARKING PERMIT Powered By Docstoc
					BUS/REN                       BUSINESS PARKING PERMIT
LB of Merton               RENEWAL / CHANGE APPLICATION FORM
All sections must be completed (please use CAPITAL LETTERS).
Note Declaration overleaf
COMPANY NAME

BUSINESS ADDRESS
Within Zone




TELEPHONE NO(s)            Work                                Mobile


PERMIT NUMBER/S


Existing                                      Existing
Vehicle Registration                          Vehicle Registration

New Vehicle Registration                      New Vehicle Registration
If Applicable                                 If Applicable

Make and Model                                Make and model

Colour                                        Colour


I have enclosed a covering letter on headed paper stating why the issue of a permit is
essential to the continuation of the business




------------------------------------------------------------
FOR OFFICE USE ONLY

ZONE/SUB-ZONE                               Documents          Checked by        Date
                                            Business Addr.
PERMIT NUMBER.                              Letter

EXPIRY DATE




                                  HELPLINE 020 8545 4661
DECLARATION
Please sign and date the declaration. Note that a false statement could lead to prosecution by
the Council on fraud charges.

I declare:

i) That all the information given in this application is correct and that the vehicle described does
not already hold another Business Parking Permit. I understand that if, during the currency of
any permit, I cease to work at the address and/or I cease to be the keeper and user of the
vehicle specified in this application that I am required by law to destroy the Permit or return it to
the Parking Services Section of the London Borough of Merton and that it will be an offence for
me to continue to use the permit.

For the prevention and protection from fraud data may be checked to, or against, other
information or may be passed on to other public bodies for verification.

Company Name (in block capitals)


Full Name (in block Capitals)


Signature



Return completed form to: Parking Services,
                          Merton Civic Centre,                                      Date
                          London Road
                        Morden
                        Surrey SM4 5DX



PAYMENT
I enclose a cheque/postal order for the sum of £_______________ made payable to the London
Borough of Merton. Please write the applicant’s name and address on the reverse of the
cheque.

   CARD PAYMENT – BARCLAYCARD/MASTERCARD/VISA/MAESTRO/DELTA/SWITCH ONLY

To the London Borough of Merton:
Please debit my credit/debit card with the amount of £

CARD NO

Card                                                   Start Date               Expiry Date


Signature                                                   Switch Card Issue Number
& Date

				
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