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City of Washington, NC

Application for Business Privilege License
Police Investigation Report and Certification

 
Police Investigation Report
 
Applicant's Full Name:
Date of Birth:
NC Driver's License No.:
Social Security No.:
Race: Sex:
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FOR POLICE DEPARTMENT USE ONLY

POLICE DEPARTMENT CERTIFICATION

I, ___________________________________________ CERTIFY THAT THE APPLICANT ABOVE HAS BEEN INVESTIGATED BY THE WASHINGTON POLICE DEPARTMENT. BASED ON THE FINDINGS IN THIS INVESTIGATION, I RECOMMEND THE FOLLOWING:

 

THIS APPLICANT MAY BE ISSUED A BUSINESS LICENSE ____________________________

THIS APPLICANT SHOULD NOT BE ISSUED A BUSINESS LICENSE ____________________

CHIEF OR AUTHORIZED PERSON: __________________________________________

DATE: _______________________________

 
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