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Pawnbroker Application

  1. Logo lower case.JPG

  2. Pawnbroker Application


    City Clerk's office
    City Hall, 2nd Floor
    Kathleen P. Salisbury, City Clerk
    400 Washington Street
    Burlington, Iowa 52601

    Questions? (319) 753-8124

  3. Effective April 1st through March 31st

    Yearly License - $230.00

  4. SECTION I - NAME & ADDRESS

  5. SECTION II - CORPORATION INFORMATION

  6. Is applicant a corporation? If yes, complete this section. If not, go to Section III

  7. Stockholder Information - list all

  8. Corporation Directors & Officers - list all

  9. SECTION III - PARTNERSHIP INFORMATION

  10. Is applicant a partnership? If yes, complete this section. If not, go to Section IV

  11. General Partners

  12. Limited Partners

  13. SECTION IV - SOLE PROPRIETOR INFORMATION

  14. Your electronic signature below indicates your agreement with the following statements: By typing my name in the following box and clicking the submit button I certify the above statements to be true and correct, to the best of my knowledge.

  15. _______________________________

    Eric Tysland, Development & Parks Director

  16. _____________

    Date

  17. _______________________________

    Doug Beaird, Police Chief

  18. _____________

    Date

  19. Leave This Blank:

  20. This field is not part of the form submission.