Action Center / Business License - Pawnbroker, Second-Hand & Junk Dealer License Application / Davenport, Iowa

General Information

Business Name*

Parent Company Name

Country*

Address*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region*

Postal Code*

Country*

Address*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region*

Postal Code*

Business Phone*

Phone Area Code-Phone 3-Phone 4 ext Extension

Cell Phone

Phone Area Code-Phone 3-Phone 4

Business Start Date*

MonthDay Year,

Ownership*

Email*

Website URL

ProtocolURI

Owner's or Principal's Name(s)

Owner or Principal's Name 1*

Address*

City*

State*

ZIP*

Zip-Zip +4
Second portion of ZIP Code is optional.

Owner Phone 1*

Phone Area Code-Phone 3-Phone 4 ext Extension

Title Owner 1*

Employment History (5 years)*

Owner Name 2

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Please Do Not Complete The Following Field

Owner 2 Phone

Phone Area Code-Phone 3-Phone 4 ext Extension

Owner 2 Title

Employment History (5 years)

Has any owner/manager been convicted of a misdemeanor or felony (excluding traffic violations) in the past 10 years?*

Yes

No

If yes, please list person's name, charge, and date of conviction.

Has any owner/manager had a license suspended or revoked?*

Yes

No

If yes, please list the reason and location of suspension/revocation.

Real Estate Owner Information

Country

Address

Address 2

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region

Postal Code

License Specific Information

If Antique or Second Hand Dealer:

Whose business involves 10% or less of business items requiring record of transaction and licensed as a second hand dealer.

Whose business involves more than 10% of business items requiring record of transaction and licensed as a pawnbroker

Items requiring a record of transaction: Items of gold, silver, platinum, copper, other precious metals, gems and jewelry; Collections of 10 or more coins or bills of currency; Items with serial numbers or model numbers including, but not limited to, appliances, tools, electronics, computers, gaming systems and accessories; Musical instruments; Compact discs, computer software, and video game cartages; Scrap metal products; Firearms.

Attachments:

A financial statement (business or personal bank statement or balance sheet)identifying all sources of funding that will be used to support the business

Fee Schedule:
0012 2nd Hand Dealer No Reporting - $50.00
0013 2nd Hand Dealer Police Report - $300.00
0135 Itinerant Dealer - $500.00
0142 Junk Dealer $300.00
0170 Pawnbroker $300.00
0033 Antiques less than 10% Report - $50.00
0034 Antiques more than 10% Report - $300.00

Business License - Pawnbroker, Second-Hand & Junk Dealer License Application

Business License - Pawnbroker, Second-Hand & Junk Dealer License Application

General Information

Owner's or Principal's Name(s)

Real Estate Owner Information

License Specific Information

Dialog Title