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Owner's Application for License to Operate a Massage Business

Business Information

Suite, etc.

Nature of Ownership
Corporation Information

Apt., Suite, etc.

List names and addresses of any Operator(s)/Manager(s) or other persons principally in charge of operation and all employees.

Full Name Address
person
Partnership Information

List partners.

Full Name Address Phone

Have any of the partners listed above ever been convicted of a felony, a crime involving moral turpitude, a crime involving controlled dangerous substances, an offense involving sexual misconduct, or any offense involving the use of force or violence upon someone, or another crime that would amount to a felony? If your answer if yes to any of the above questions, explain in detail.

Authorization
I, the applicant, do hereby authorize the City of Moore, it`s agents, or anyone designated by the City of Moore to contact any source to verify the information supplied in this application.
Verification
I, the applicant, under penalty of perjury do hereby declare that I have examined this application and all statements contained herein and to the best of my knowledge and belief, they are true, correct, and complete.
Applicant Information
Two (2) Previous Addresses Prior to Current Address
Physical Description

Have you ever been convicted of a felony, a crime involving moral turpitude, a crime involving controlled dangerous substances, an offense involving sexual misconduct, or an offense involving the use of force or violence upon someone, or another crime that would amount to a felony? If your answer is yes to any of the above questions, explain in detail.

List all prior Massage Establishments or similar business history and experience for the last ten (10) years.

Have you ever had a prior license to operate a massage establishment in this or any other City or State denied, revoked, or suspended? If yes, state the reason.

Authorization
I, the applicant, do hereby authorize the City of Moore, it`s agents or anyone designated by the City of Moore, to contact any source to verify the information supplied in this application.
Declaration
I, the applicant, do hereby authorize the City of Moore, it`s agents or anyone designated by the City of Moore to contact any source to verify the information supplied in this application.

List Three (3) Adult Residents in this County, other than relatives or business associates who would serve as character references.

Full Name Address Phone
Agreements

Information message

Please read the municipal code: Division 2 Massage Establishment License
Once you have finished, initial the Municipal Code Agreement field below. 

I Agree (initial)

By initialing, you agree that you have read and understood the municipal code provided above.

By signing and submitting this form, I certify that the information provided is true and accurate to the best of my knowledge.

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City of Moore Seal

VANESSA KEMP
City Clerk
[email protected]

CITY CLERK`S OFFICE
City Hall
301 N. Broadway
Moore, OK 73160
405-793-5020