§ 17-67. Application.

Applicants for licenses under this division shall file an application with the director of excise and licenses, on forms to be provided by the director for that purpose, which shall contain the following:

(1)

The name of the person by whom the applicant is to be employed; the address where the applicant is to be employed; the nature of the services to be rendered; the purpose of the employment; and other pertinent facts required by the director;

(2)

A statement as to whether or not the applicant has been convicted of any felony, misdemeanor, or ordinance violation (including traffic violations), the nature of the offense, the penalty or punishment imposed, and the date and place where such offense occurred;

(3)

A statement as to the business or employment record of the applicant for the ten (10) years immediately preceding the date of the application;

(4)

A certificate of a licensed physician reciting that the applicant has been examined by the physician within sixty (60) days preceding the application and was found to be free of any defects which would affect the ability of the applicant to operate a private emergency vehicle satisfactorily.

(Code 1950, § 974.3)