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2. 
4. Finance Office
   PO Box 2007
   211 N Elm St Jenks OK, 74037
   918-299-5883
   
6. This form is valid when countersigned by the City Clerk. Permit No.
10. Vending Machine Owner*
12. Address*
14. City
15. State
16. Zip Code
18. Contact Person*
19. Contact Phone*
21. Location of Vending Machine*
23. Location Business Name*
25. Oklahoma Tax Commission Coin-operated Device Permit No.(s).*
27. If multiple locations, use separate application for each location.
29. Use the table below to indicate on the lines provided, the quantity of each type of coin-operated device you own or operate within the city limits of the City of Jenks. Charges are for an annual permit and each permit will expire on June 30th of each City fiscal year. If you have any questions, please call (918) 299-5883 and ask to speak to Vending permits in the Finance Department.
31. Return this registration within ten business days with the appropriate payment to:
34. City of Jenks
    ATTN: VENDING LICENSE
    PO Box 2007
    Jenks, OK 74037-2007
    
36. You may also come in person to Revenue Collections on the 1st floor of City Hall at 211 N. Elm St.
38. FAILURE TO SUBMIT THIS APPLICATION WITHIN THE TEN BUSINESS DAYS MAY RESULT IN PENALTIES AS INDICATED BELOW
40. Device Type
    Coin-operated game, music, movie, soft drink, machine et al as defined by OTC, payment .25 or more. Excludes bulk machines such as gumball, peanuts, etc
41. Quantity*
43. Unit Price @ $37.50ea
44. Price*
45. Total*
49. UPON RECEIPT OF THIS APPLICATION AND THE APPROPRIATE PAYMENT, THIS APPLICATION WILL SERVE AS YOUR LICENSE. A STICKER WILL BE PROVIDED TO BE PLACED IN A LOCATION ON YOUR MACHINE(S) VISIBLE TO THE USER AS PROOF OF SAID LICENSE.
51. Any person who violates or fails to comply with any provision of City Code §5-1-1(A) (11) and /or (12) or any legal order or regulation made pursuant thereto, shall be guilty of an offense, and upon conviction thereof shall be punished by a fine of not more than two hundred ($200.00), plus court costs. Each day upon which a violation continues shall be deemed a separate offense
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