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2. City of Buda "No Solicitation" Registration Form

   Pursuant to City of Buda, Code of Ordinance Sec. 14.02.007 Peddlers and Solicitors, Subsection (l)(B) All solicitation prohibited at specified locations, the following individual has filed a “no solicitation registration form” with the city for that purpose. The city will maintain a “no solicitation” list of those persons who wish to restrict solicitation on their property by canvassers, peddlers, and solicitors. The “no solicitation” list shall be a public document and a copy of the list shall be provided to each recipient of a permit to engage in solicitation.

4. Salutation*
5. First Name*
6. Last Name*
8. Address1*
9. Subdivision*
11. City*
    Restrictions may apply. See residency requirement.
12. Email Address*
14. Phone Number*
16. Acknowledgement

    The resident hereby acknowledges this form is a public document.  The document will be kept on file with the City of Buda’s Office of the City Clerk or until the resident revokes this form.  The resident is responsible for updating their registration.  

18. 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.

    1. I agree.
20. Electronic Signature*
21. Date*
    Date

    Date
Leave This Blank:


23. 1. Receive an email copy of this form.
24. Email address

    This field is not part of the form submission.

25. Submit Submit and Print

* indicates a required field