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City of Stockton Hotel/Motel Managers Permit Application Paae 2 <br /> 2. In the past three years, have you ever had a Manager's Permit denied, revoked or suspended <br /> within the State of California? ❑ Yes ❑ No <br /> y- If so, please provide the reason for denial, revocation and/or suspension: <br /> 3. Have you ever applied for a hotel, motel and/or residential hotel/motel manager's permit using <br /> a different name? ❑ Yes ❑ No <br /> y If so, please provide the other name: <br /> 4. As the property owner, operator, manager and/or lessee of a hotel/motel, within the last five <br /> years, have you terminated your lease, defaulted on your loan, or otherwise discontinued your <br /> association with the property while violations as cited in a Notice of Violation, Notice and <br /> Order, Administrative Citation, etc. were still outstanding? ❑Yes ❑No <br /> y If so, please describe: <br /> 5. Are you currently on probation or parole? ❑ Yes ❑ No <br /> > If so, are you required to register each year❑ YEs No <br /> 6. Each manager and/or other person connected to the management of the business must <br /> complete a separate application and attach the following information (SMC §7-111.31) <br /> ❑ Department of Justice Background Check Application <br /> ❑ Two passport-size identity prints of the applicant (can be obtained through the Police <br /> Department at the time of fingerprinting at an additional cost) <br /> ❑ Registration for Residence Course of Study <br /> ❑ Written evidence that the applicant is 18 or older (i.e. copy of legal form of identification <br /> showing date of birth) <br /> I hereby certify under penalty of perjury that that above information is true and <br /> correct to the best of my knowledge and belief. <br /> AUTHORIZED SIGNATURE DATE <br /> -Fees are effective from 07/01/2019—06/30/2020 <br />