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Business License 38250 Sierra Highway Palmdale, CA 93550 661/247-8384 661/267-5434 [EMAIL REDACTED] [EMAIL REDACTED] TOW TRUCK DRIVER This Application is for (check one) New Permit Annual Renewal Legal Name of Applicant: Home Address: Telephone Number and Email: California Driver’s License Number and Expiration Date: Social Security Number: Tow Truck Company: Business Address: Business Telephone Number: The Tow Truck operator’s proposed service area: Statement as to whether the applicant has ever been convicted of any crime, misdemeanor, or violation of any municipal, state or federal law, the nature of the offenses, and the punishment or penalty assessed therefore: PLEASE ATTACH A COPY OF THE FOLLOWING INFORMATION: • The applicant’s Livescan fingerprinting and photo to be taken at the City of Palmdale’s Human Resources after payment of permit. • LASD License Detail Personal Information form. • A photocopy of a valid California Driver’s License. I declare under penalties of perjury that this application is true and correct to the best of my knowledge and belief. Signature Title Date OFFICE USE ONLY Recommend ( ) Not Recommended ( ) Los Angeles County Sheriff’s Dept: Signature Date Planning Manager: Signature Date Tow Truck Driver REV. 10/11/22