REQUEST TO BE LISTED on the PEDDLERS / SOLICITORS "DO-NOT-KNOCK REGISTRY" for the City of Broadview Heights
Pursuant to Ordinance #134-06, I am requesting that the residence listed below, of which I am an occupant, be listed on the Broadview Heights, Ohio "Peddlers/Solicitors Do Not Knock Registry".
I understand that this information will be available on the City's website and for viewing at City Hall during normal business hours.
I also understand that solicitors are not required to register at City Hall and may not be aware of the registry. Therefore, I will place a "NO SOLICITATION" sign on my door to further deter uninvited solicitors.

Address___________________________________________________________________

Name__________________________________________________________

Signature_______________________________________________________ 

Date________________________

This residence will remain on the list until the earliest of any of the following:

1. The City receives a Notice of Removal form.
2. The City receives notice that the person who submitted the form no longer occupies the premises.
3. The expiration of five (5) calendar years expiring on December 31st from the date of the form.

Return this signed form to City Hall by mail, fax, or scanned e-mail.  Please allow four (4) days to process

Address:
9543 Broadview Road
Broadview Heights, OH 44147

Fax: 440-717-4004

E-mail:  eityhall@broadview-heights.org