Business Rental Agreement

							                              CITY OF OAKLAND - PARKING DIVISION
                       RESIDENTIAL/BUSINESS PERMIT PARKING APPLICATION
RESIDENTIAL:                            New                Renewal             Replacement                   Visitor

BUSINESS:                               New                Renewal             Replacement            Transferable


AREA :                                                                       Permit Account #:


                                                                                      FOR OFFICE USE ONLY:
NAME :
                 LAST                             FIRST               MIDDLE INITIAL Permit No. (s)

ADDRESS:
                 Number & Street
                                                                                      Permit Expiration Date :

CITY                                              STATE               ZIP CODE                      June 30, 200

PHONE:           (     )                                  (      )                    Visitor Permit No.
                  HOME                                     BUSINESS
                                                                                      Effective Date (s)
                                                                                                                       Circle one
LICENSE PLATE                                                                         No. of Permits Issued:      1           2     3

          1                                                                           Amount paid

          2                                                                            Cash      Check           Credit Card

          3

VEHICLE MAKE                                                                                     Current vehicle registration

          1                                                                                                      And
          2                                                                                      Driver's License

          3                                                                                      Utility bill or rental agreement

                                                                                                 Business License (business only)
The following documents are required for permit processing and
approval:
           1     Current vehicle registration
           2     Driver's License                                                     Approved by Supervisor                            Date
           3     Utility bill or rental agreement
           4     Business License (business only)                                     FOR LOCKBOX PROCESSING USE ONLY:
I certify under penalty of perjury that the above statements are true. I
understand submitting false information could result in immediate
revocation of the residential/business parking permits.                               Information Verified by Mail Clerk                Date

                                                                                      Payment Processed by PSR                          Date

SIGNATURE                                                             DATE            Permit Issued by                                  Date


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