1. Print Name ..............................................................................................................................................................................................................................

2. Street Address ........................................................................................................................................................................................................................

3. City ....................................................................................State ................................................. Zip Code..........................................................................

3. Make of Car .......................................................4. Type of Car ..........................................................5. License Plate #...............................................

I agree that the Incorporated Village of Floral Park shall not be liable for any loss of or damage to the above described motor vehicle or its equipment, occurring while such motor vehicle is parked in any licensed parking area in said Village. Issuance of a permit does not guarantee a parking spot. All permits issued are non-refundable. The parking license tag issued herewith must be securely attached to the rear left bumper of the licensed car. .It is understood that the permit is void if attached to any other vehicle.  Submit proof of car registration with application. Enclosed is $                                        in payment of the License Fee required under said Ordinance.

............................................................................................................................................................................................Signature of Owner

Parking License No. ..........................................................Date of Issue ................................................ EXPIRES....................................................................
                                                                                                        (Do not write in above spaces)

A License pursuant to Chapter 96, Article XIV of Village Ordinance is hereby granted to:

Print Name ................................................................................................ Address .......................................................................................................................
to park the following described motor vehicle in licensed parking area described in said Ordinance FOR A 24 HOUR PERIOD:

1. Make of Car .................................................2. Type of Car ............................................ 3. License Plate #............................................................

The Village assumes no responsibility for loss of or damage to the above described motor vehicle or its equipment while the same is parked in a licensed parking area. Issuance of a permit does not guarantee a parking spot. All permits issued are non-refundable. The parking license tag issued herewith must be securely attached to the rear left bumper of the licensed car. It is understood that the permit is void if attached to any other vehicle.

Parking License No. ..........................................................Date of Issue ................................................ EXPIRES....................................................................
                                                                                                       (Do not write in above spaces)

A License pursuant to Chapter 96, Article XIV of Village Ordinance is hereby granted to:

Print Name ................................................................................................ Address .......................................................................................................................

to park the following described motor vehicle in licensed parking area described in said Ordinance FOR A 24 HOUR PERIOD:

1. Make of Car .................................................2. Type of Car ............................................ 3. License Plate #...........................................................

The Village assumes no responsibility for loss of or damage to the above described motor vehicle or its equipment while the same is parked in a licensed parking area. Issuance of a permit does not guarantee a parking spot. All permits issued are non-refundable. The parking license tag issued herewith must be securely attached to the rear left bumper of the licensed car. It is understood that the permit is void if attached to any other vehicle.