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Town of Pahrump 2100 E. Walt Williams Dr., Suite #100 Pahrump, NV 89048 Phone: [PHONE REDACTED] Fax: [PHONE REDACTED] E-mail: [EMAIL REDACTED] Seller Permit Must be on display for public view at all times. Business Name: Type of Items: Nevada State Business License (REQUIRED): Nevada Sales/Use Tax Permit: Dates of Sale: Location of Sale: Signature of Applicant: _ Property Owner: Property Contact Number: Property Address or APN# Signature: In signing this document the property owner authorizes the above named business/individual to offer products and/or a service from the location listed and is not responsible for permits or licenses required. Application received by: Date: Expiration Date: # Vendors x $5.00 fee per vendor = Total Due $ Issued in accordance with Pahrump Town Ordinance # 35, this permit is subject to renewal every 30 days. Please attach the following: A copy of the Nevada Business License and Sales/Use Tax Permit or Exemption. Not Valid unless Embossed with Town of Pahrump Seal Certificates of Insurance for Workman’s Compensation for employees or Affirmation of Compliance. If you are a corporation or LLC, we also need a copy of your articles of incorporation or organization and list of officers. If you are a sole proprietorship or partnership, we need child support declaration(s) filled out and signed by the owner(s). If you are serving food or beverages, you must attach a copy of your health inspection. Child Support Declaration I, the above mentioned applicant, ( am; am not) subject to a court order for child support and (am; am not; n/a) in compliance with the order or a plan approved by the District Attorney or other public agency enforcing the order for the payment of the amount owed pursuant to the order. Initial