Please provide the following information for participation in the Residential Decal Program. Return this completed form with your annual fee of $20.00. If you wish to purchase the Residential visitor permit at this time, include an additional $20.00.

Date __________________________

Name (Print) Last ________________________First________________________

Street Address______________________________Apt.#________________

City _____________________________State ________Zip_____________

Business Phone_________________________ Home Phone ____________________

Registered Vehicle: (If your license plate no. has the number zero, enter as Ø.)

Make __________ Model ___________ Year ________Veh Lic #___________

Color__________ State of Registration ________Body Type ___________

RULES, REGULATIONS AND CONDITIONS

1. Attach to this registration proof of ownership of the home address or provide a copy of the lease agreement.
2. A new registration form must be submitted annually to continue participation in the program, expiration date on decal serves as notice.
3. If the vehicle is sold or title is transferred, the decal will be replaced at no charge when returned; if not returned, written notice is required along with a replacement fee of $5.00.
4. Documented misuse or abuse of the decal will result in a suspension of privileges for a period not to exceed one (1) year.
5. Vehicle is subject to citations and towing for overtime parking in a commercial or residential loading zones if parked for more than 20 minutes.
6. Visitor permit is subject to #'s 4 and 5 above.
7. A refund is allowed only in the event of an initial rejection of this registration.
8. Only one (1) decal and one (1) visitor permit is allowed per address.
9. If a decal or visitor permit is lost, stolen or misplaced, only one (1) replacement will be issued within one (1) year period. Replacement fee is $5.00.
10. Decal is non-transferable. It is the decal holders responsibility to contact the Parking Division of any changes in vehicle status.

I hereby consent and agree to abide by these rules, regulations and conditions and confirm that I have fully read and understand the above.

Signature_________________________

Please check appropriate purchases which apply:

DECAL_____$20.00 VISITOR PERMIT_____$20.00

CERTIFIED MAIL DELIVERY____$5.10

TOTAL AMOUNT OF CHECK OR MONEY ORDER SUBMITTED__________________

FOR OFFICIAL USE ONLY

Permit #_____________Date Issued____________ Expiration Date________________

Amount Paid_____________Cash________ Check____#_________MO____________

Pick Up___________ Delivery by Certified Mail ________________________________

Visitor Permit# __________ Date Issued ____________Expiration Date____________

Return complete registration form to:

fax to (210) 207-8269 Attention Parking Enforcement Section.

If you require additional information concerning this program, please contact the Parking Division at 207-8277.

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