City of Morgan Hill - e-Service Center

( Required field)*
*Select one of following licenses:	BINGO TAXI ENTERTAINMENT MASSAGE: PRACTITIONER ESTABLISHMENT

*Name of Organization:
Address:
*Street:
*City:
*State:
*Zip:
*Business Phone:
List the following owner/officer information:
Owner/President:
*First Name:
*Last Name:
Address:
*Street:
*City:
*State:
*Zip:
*Business Phone:
*Home Phone:
*Date of Birth:	/ / ( MM / DD / YYYY )
Nickname/Alias:
*Drivers Lic.#:
	State:
*Soc.Sec. #

Co-Owner/Vice-President/Manager:
First Name:
Last Name:
Address:
Street:
City:
State:
Zip:
Business Phone:
Home Phone:
Date of Birth:	/ / ( MM / DD / YYYY )
Nickname/Alias:
Drivers Lic.#:
	State:
Soc.Sec. #

Co-Owner/Treasurer/Co-Manager:
First Name:
Last Name:
Address:
Street:
City:
State:
Zip:
Business Phone:
Home Phone:
Date of Birth:	/ / ( MM / DD / YYYY )
Nickname/Alias:
Drivers Lic.#:
	State:
Soc.Sec. #

Co-Owner/Secretary/Co-Manager:
First Name:
Last Name:
Address:
Street:
City:
State:
Zip:
Business Phone:
Home Phone:
Date of Birth:	/ / ( MM / DD / YYYY )
Nickname/Alias:
Drivers Lic.#:
	State:
Soc.Sec. #