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<br />APPh'tcanlll t Slignature _ This application cannot be processed if not signed by an owner, officer partner director or stockholder with
<br />a con ro ng nterest. ' ,
<br />53una.der the penalties of perjury, I declare that I have read this application and that the facts stated in It are true. [ss. 92.525(2)
<br />09, . and 837.06, Florida Statutes] ,
<br />
<br />ml III , 11111 1I1\llltlll , Illtlll II
<br />
<br />All applicants MUST answer Questions 1 through 7.
<br />
<br />1. Are you a secondhand dealer as defined in section
<br />538.03(1), F.S.? A secondhand dealer engages in the
<br />business of purchasing, consigning, or trading sec?3Endh nd
<br />goods ftom a fixed location. ........................ 0 Yes No
<br />2. Are you a secondary metals recycler as defined In secti
<br />538.18, F.S.? A secondary metals recycler has facilities for
<br />performing the manufacturing process by which ferrous
<br />metals or nonferrous metals are converted into raw material
<br />products consisting of prepared grades and having an
<br />existing or potential economic value, other than by the
<br />exclusive use of hand tools, by methods Including, without
<br />limitation, processing, sorting, cutting, classifying, cleaning,
<br />baling, wrapping, shredding, shearing, or Changing ~
<br />physical form or chemical content thereof... 0 Yes ~o
<br />
<br />3, Do you agree to comply with the record keeping
<br />requirements of Chapter 538.04, F.S. (secondhand dealers)
<br />
<br />~~.~~~:.~~~.~~~:~~:.~.~:.~~~~.~.~.~~~.:~~~I.~:rS)?o No
<br />
<br />4. Do you agree to allow for inspection of your records,
<br />property, and premises as required by Chapter 538.05, F.S.
<br />(secondhand dealers) or Chapter 538.20, ~S.Jsecondary
<br />metals recyclers)? ...................................~yes 0 No
<br />
<br />5. Do you agree to comply with the holding period
<br />requirements as provided In Chapter 538.06, F.S.
<br />(secondhand dealers) or Chapter 538.21, ,c.Syecondary
<br />metals recyclers)? .....................................~Yes 0 No
<br />
<br />6. Has your business paid all the sales and use tax owed to
<br />the Department of Revenue as required by s. 538.09, F.S.
<br />(secondhand dealers) or 538.25, F.S. (sec~ metals
<br />recyclers)? ......N.Gr.ler.-:........................~~ 0 No
<br />
<br />7. Are you 18 years or older? .........................~s 0 No
<br />
<br />
<br />DR-1 S
<br />R. 07/08
<br />Page 4
<br />
<br />Secondhand dealers MUST answer Qumrtions 8, 9,
<br />and 10. Secondary metals recyclers should skip to
<br />Question 11.
<br />
<br />8. Within the preceding 10 years, have you or other owners,
<br />officers, partners, directors or stockholders with a
<br />controlling interest been convicted of, or entered into a
<br />plea of guilty or nolo contendere to, a crime committed
<br />against the laws of this state or any other state or of the
<br />United States involving theft, larceny, dealing in stolen
<br />property, receiving stolen property, burglary, embezzlement.
<br />obtaining property by false pretenses, possession of
<br />altered property, any felony drug offense, ~tIly violation of s.
<br />812.015, F.S., or any fraudulent or dishonelst dealing?
<br />
<br />....................................................................0 Yes ~
<br />
<br />9. Have you ever made a misrepresentation cr false statement
<br />to, or concealed any essential or material fact from, any
<br />
<br />~~~~~.~~.:~~.~.~..~.~~~~~~~.~~.~.~~~.~~.~~~.~~d~:;~;?
<br />
<br />10. Have you ever had a final judgment entered against you
<br />In civil action upon grounds of fraud, embezzlement
<br />misrepresentation, or deceit? ....................... 0 Yes ~o
<br />
<br />Secondary metals recyclers MUST answer Question 11.
<br />
<br />11 . Within the preceding 24 months, have you or other
<br />owners, officers, partners, directors or sto,::kholders with
<br />a controlling Interest been convicted of, or entered a plea
<br />of guilty or nolo contendere to, a felony ccommltted against
<br />the laws of the state or of the United StatE~S involving theft,
<br />larceny, dealing In stolen property, receiving stolen property,
<br />burglary, embezzlement, obtaining proper~( by false
<br />pretenses, possession of altered property: or any felony
<br />drug offense or of knqW}')Q~ or intentionally violatin~ ~,
<br />laws of the state? ...4.lr..(......................... 0 Yes ~o
<br />
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