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Updated 9/26/2024 CITY OF MOSCOW SECOND-HAND DEALER & PAWNBROKER LICENSE NEW APPLICATION THE CITY OF MOSCOW REQUIRES: 1. A processing fee of sixty-two dollars ($62) with this Application which includes the background check and fingerprinting charges. 2. A valid Driver’s License or valid government issued identification to be shown and copied. 3. Completed Authorization and Release Form. Full Name of Applicant: Social Security Date of Birth: Sex: Height: Weight: Eyes: Hair: Name of Business: Business Mailing Address: Business Location (if different from above): Business Phone: Home Phone: Fax Phone: Email Address: Have you been found guilty of, plead guilty to, received a withheld judgment, or admitted to the elements of any crime involving any felony, theft, possession of stolen property, or moral turpitude, or admitted that sufficient evidence exists where a judge or jury could find the applicant guilty beyond a reasonable doubt of the above listed crimes? [ ] No [ ] Yes If answered “Yes” to above, please explain: READ CAREFULLY: I have read all of the above and declare under penalty of perjury pursuant to the law of the State of Idaho that each and every statement made is true, correct, and complete. I understand that an investigation and background check will be made on all information contained in this application and authorize the City to conduct such investigation. SIGNATURE TITLE DATE STATE OF ) ) ss: County of ) Subscribed and sworn to before me this day of , . Residing at My Commission Expires: Clerk/Deputy Signature