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<br />Proposal for Towina Services <br /> <br />1. Business Name: <br />2. Business Address: <br />Phone: <br />Mailing Address: <br /> <br />City: <br /> <br />Zip: <br /> <br />City: Zip: <br />State type of business enterprise (e.g. corporation, association, partnership, organization, joint venture, <br /> <br />trust, foundation, firm, group, society, individual natural person, etc.): <br />3. NAME ALL OWNERS, OFFICERS, AND PERSONS HAVING AN INTEREST IN THE TOWING AGENCY: <br />(Attach additional sheets if necessary) <br />a. NAME SS# <br /> ADDRESS PHONE <br /> CITY STATE BIRTHDATE <br />b. NAME SS# <br /> ADDRESS PHONE <br /> CITY STATE BIRTHDATE <br />c. NAME SS# <br /> ADDRESS PHONE <br /> CITY STATE BIRTHDA TE <br />d. NAME SS# <br /> ADDRESS PHONE <br /> CITY STATE BIRTHDATE <br />e. NAME SS# <br /> ADDRESS PHONE <br /> CITY STATE BIRTHDA TE <br /> <br />4. Has the business enterprise, or any person whose name appears in this application, ever been convicted of any <br />crime? <br /> <br />If so, list the name, the arrest and conviction record of each person: <br />(Attach Additional sheets if necessary) <br /> <br />5. If a corporation, supply the following: <br /> <br />A TT ACHMRNT "C''' <br /> <br />25 <br />