Pursuant to Ord. #134-06, I am requesting that the address listed below, of which I am an occupant, be listed on the Broadview Hts,, 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.

House Number*

Street*

Apt. No. (if applicable)

First Name*

Last Name*

Date*

Email Address:*

ELECTRONIC SIGNATURE:

By checking the box above I am hereby providing my signature electronically.

This residence will remain on the list until:g:
1) The City receives a written notification of removal.
2) The City receives notice that the person who submitted the form no longer occupies the premises.
3)

Please allow 4 days for processing.

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Note that solicitors are NOT REQUIRED to register at City Hall & may not be aware of the Do Not Knock Registry. Therefore, please place a "NO SOLICITATION" sign on your door to deter uninvited solicitors. Ord. 828.05 states that "...no person..shall call at any residence in the City which displays a no-solicitation sign.."