Valuable Metal Dealer Business License Application

Valuable Metal Dealer Business License Application
Applicant Information

This is an application for a Valuable Metal Dealer business license per Chapter 4.22 (Valuable Metal Dealers) of the Bloomington Municipal Code. No person, Partnership, association or corporation shall engage or continue in business as a valuable metal dealer except as authorized by this chapter and without first obtaining a license from the City Controller. This license is good for one year from the day it is issued. If you have any questions, call us at (812) 349-3418.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2

CityState

Zip Code
Business Name
Business Address (if different from Home)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Type:
Other:
Company Officer Information
Provide the names and addresses of all principle officers, partners, trustees, owners or other persons with controlling interests in the company.
The undersigned, agrees that in the event the applicant as licensee receives merchandise of any kind which is stolen, they claim no right, title or interest in and to said merchandise, and that upon request by a law enforcement official having probable cause to believe that the merchandise is stolen, they will voluntarily surrender said merchandise to the possession of that law enforcement agency when given a receipt for the same. Signature below.
Should be Empty:

Valuable Metal Dealer Business License Application

Applicant Information

Company Officer Information