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City of Star P.O. Box 130 Star, Idaho 83669 [PHONE REDACTED] [EMAIL REDACTED] Vendor Employee Information & Consent Form #225 Rev 01-2023 VENDOR EMPLOYEE INFORMATION & CONSENT Every employee working for a Business applying for a Vendor Permit must fill out an Employee Information Sheet and Consent to Record Search form. A copy of a valid driver’s license or identification card must be attached. Employee Name: Employee Address: Employee Phone: Employee Email: Have you ever been convicted of a violation of any federal, state or municipal law? Yes If yes, state the nature of the offense and date. Also, list the punishment and penalty. NOTE: Upon receipt of an application the City will refer the application to the Star Police Department or the Idaho State Police Department, at which time an investigation into criminal background, warrants, and driving records will be performed. If denied due to negative background results, applicant has up to ten (10) days to request a copy of results; after ten (10) days results are not available. In cases where an application is denied and then appealed by the applicant, all investigation material will be presented to the Council. CONSENT TO RECORD SEARCH I, AKA (list any HEREBY GIVE MY PERMISSION TO THE CITY OF STAR TO HAVE A POLICE RECORD SEARCH CONDUCTED IN REFERENCE TO MY APPLICATION FOR A VENDOR, SOLICITOR, TEMPORARY MERCHANT APPLICATION. This form expires 15 months after the date signed below. SIGNATURE DATE STAR CITY POLICE DEPARTMENT NOTES: REVIEWED BY: OFFICER & BADGE NUMBER DATE NOTE: Upon receipt of an application the City Clerk will refer the application to the Star Police Department or the Idaho State Police Department, at which time an investigation into criminal background, warrants, and driving record will be performed. Per Star City Code 2-4-5B if applicant has made a false statement on the application, the application may be denied. In cases where an application is denied and then appealed by the applicant, all investigation material will be presented to the Council.