Solicitors Permit Application

2. City Clerk's Office
   (712) 328-4616

   (712) 328-4616

4. Name of Business

6. Name of Owner/Manager

8. Mailing Address

10. City

11. State

12. Zip

14. Location of Business

    If different than mailing address

16. City

17. State

18. Zip

20. Purpose of Solicitation

22. List all Employees going door to door

24. Dates and times employees will be going door to door

26. I hereby Certify that I am of good moral character and a citizen of Council Bluffs, Iowa.

28. Signature

Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field