HomeMy WebLinkAboutBusiness APP TNCclerk/t TNC app.doc
04/16
TRANSPORTATION NETWORK COMPANY (TNC) – Due by May 1
BUSINESS APPLICATION FEE — $1000 (Payable to City of Iowa City)
1. Name of Business
2. Business Address
Email address: ____________________________________________________________________________
(Email address will be used for notification purposes)
Name of Network Representative Contact: ___________________________________________________________
.
4. Business Telephone Number: _________________
5. Attach proof of authorization from Iowa Secretary of State to conduct business in State of Iowa.
6. Attach proof of current accreditation by the National Association of Professional Background Screeners (NAPBS) of
TNC’s third party background check provider.
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I understand that if I falsely answer any of the questions in this application, this application will be denied.
(Needs to be signed in front of a Notary Public)
Signature
Business representative
STATE OF IOWA )
COUNTY OF ___________ )
Subscribed and sworn to before me by ____________________________________ on this ___________ day of
_____________________.
________________________________________
Notary Public in and for the State of Iowa
___________________________________________________ ____________________________________
City Clerk Date