BOROUGH OF FANWOOD NEW JERSEY POLICE DEPARTMENT
                            APPLICATION FOR TOWING LICENSE
Date:_______________________ I hereby apply for a towing license for the year
beginning______________________ and ending December 31, 20__

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NAME OF OWNER/APPLICANT

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BUSINESS ADDRESS                      MUNICIPALITY                STATE

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HOME ADDRESS

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BUSINESS PHONE                  BUSINESS FAX                 HOME PHONE

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HAVE YOU EVER BEEN CONVIC 1 ED OF A CRIME? EXPLAIN.

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NAME AND ADDRESS OF INSURANCE COMPANY GARAGE KEEPERS AND BUSINESS

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POLICY NUMBER              LIABILITY LIMITS                  EXPIRATION DATE

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DESCRIBE VEHICLE THAT WILL BE USED FOR TOWING.

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DOES VEHICLE HAVE APPROVAL OF DIVISION OF MOTOR VEHICLES?          PERMIT NO.

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LOCATION WHERE TOW TRUCK IS GARAGED OR STORED.                HOURS AVAILABLE

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WHERE WILL VEHICLES BE STORED?                      NO. OF AVAILABLE SPACES

Note: A description of the storage area showing how vehicles will be stored must
be attached to This application.

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IS STORAGE AREA OWNED BY APPLICANT? IF NOT, NAME OF OWNER.

If storage area is leased, a copy of the lease must accompany this application.

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IS LEASE CONCURRENT WITH DURATION OF THIS LICENSE APPLICATION?

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RATES CHARGED. (ATTACHED LIST OF RATES)

I hereby certify that the information contained in this application as furnished
by me is true and correct. I have read and understand that non-compliance with
Chapter 89-71 to 89-86 of the Fanwood Borough Code or falsifying this application
will result in suspension or forfeiture of my towing privileges

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    SIGNED                                                  DATE