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REQUEST FOR REPRODUCTION OF PVA PUBLIC RECORDS

Steps

  1. 1. Page 1
  2. 2. COMMERCIAL APPLICANT’S CERTIFIED STATEMENT
  • Page 1

    1. 62A030 (2-08)

      Commonwealth of Kentucky
      DEPARTMENT OF REVENUE

    2. Kenton County

      REQUEST FOR REPRODUCTION OF PVA PUBLIC RECORDS AND CONTRACT FOR COMMERCIAL USERS
      (KRS 61.870, 61,874 AND 133.047)

    3. kentucky-unbridled-spirit-logo-vector

    4. 1. Application Information

    5. Please describe the records being requested.

    6. 3. The use of the information is:

    7. If the information will be used for a commercial purpose, the applicant acknowledges that the information can be used only for the stated purpose and cannot be resold to any other entity.

    8. Electronic Signature Agreement

      By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.