OFFICE OF REVENUE COMMISSION
| OFFICE OF REVENUE COMMISSION |
P.O. Box 123, Kykotsmovi, AZ 86039, (928) 734-3172 FAX (928) 734-3179
2015 TOUR LICENSE APPLICATION
(Must be 18 years old to apply for a Tour License)
⃞ New Applicant ⃞ License Renewal Previous Tour License #:________________
DBA/Company Name: __________________________________________________________
Federal Employee Identification Number or SSN Number:___________________________________________
Address: ______________________________City:_________________State________ Zip Code:__________
Telephone #: _____________________Cell Phone # ___________________ FAX #: ____________________
E-Mail Address: ______________________
Ownership Information:
⃞ Partnership ⃞ Sole Proprietor ⃞ Corporation ⃞ Step-On Guide
Other: ____________________________
Name of Owner(s): _____________________________________________________________
Type of Transportation for providing Tourism services: ⃞ Bus ⃞ Van ⃞ Rental
⃞Other _________________________________________________________________
Provide information for all vehicles conducting Tours on the Hopi reservation:
⃞ License Numbers & Description of Insured Vehicles ⃞ List Driver (s) ⃞ Copy of AZ Driver’s License
Other information:
⃞ Evidence of Certificate of Liability Insurance Site Visitation Permits issued by the Hopi Tribe - Cultural
(Hopi Tribe as Certificate Holder) Preservation Office
I hereby certify that the above information is true and correct, and that any false information provided will revoke my license.
I also certify that I agree to abide by the Hopi Tribe Ordinance No. 17 and provisions of the Tourism Policy, and all other rules and regulations of each Hopi Village.
___________________________________________________________ ________________________________________________
APPLICANTS SIGNATURE DATE
10/30/2014mk
|OFFICE USE ONLY |
| |
|Date: ______________ Amount Paid: _______________ Receipt or T.R. #: _________________ |
|HCPO Permits Issued for 2015: Y N (Initial) Entered By: ___________ |
|Tour License No.: ________________________ Date Issued: ______/ /2015______________ |
|Approved By: _______________________________ Approval Date: _____ / /2015_____________ |
|Comments: ________________________________________________________________________________________ |
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