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 AND THIS INVESTIGATION HAS SHOWN THE APPLICANT'S CHARACTER AND BUSINESS REPUTATION TO BE SATISFACTORY. BASED UPON THESE FINDINGS, A BUSINESS LICENSE MAY BE ISSUED.

CHIEF OR AUTHORIZED PERSON: __________________________________________

DATE: _______________________________

 
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