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APPLICATION FOR TOWING BUSINESS REGISTRATION

- 1 - Department of Regulatory and Economic Resources BUSINESS Affairs Division Office of Consumer Protection 601 NW 1st Court, 18th Floor Miami, Florida 33136 Tel: 786-469-2300 Fax: 786-469-2311 email: APPLICATION FOR TOWING BUSINESS REGISTRATION APPLICATION Type: Check one of the following: Initial Renewal 2yr Renewal Services Provided: Check all that apply Police Contract Tows Non-Consent Tows Consent Tows TYPE OF OWNERSHIP: Check one of the following: Corporation Sole Proprietor Fictitious Name Other _____ Date of Inc: _____-_____-____ : _____-_____-_____ : _____-_____-_____ BUSINESS INFORMATION: 1. Company Name: _____ 2. D/B/A: _____ 3. Address : _____ 4. Mailing Address: _____ 5.

- 3 - TOWING VEHICLE(S) INFORMATION (Attach a separate sheet if necessary) I, _____, the undersigned, under penalties of perjury, declare that I have read the foregoing

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