"Request for Special Event Permit" - Tennessee

Request for Special Event Permit is a legal document that was released by the Tennessee Department of Commerce and Insurance - a government authority operating within Tennessee.

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Board: 3703 Contract Security Company
Transaction: _______ Event Permit
REQUEST FOR SPECIAL EVENT PERMIT
All information must be typed or legibly printed and all questions must be answered. Submit request and a non-
refundable application fee of one thousand dollars ($1,000.00) payable to S
T
via electronic check and/or
TATE OF
ENNESSEE
credit/debit card.
Contract Security Company: ____________________________________________________
Contract Security Company License Number: __________________
Fee: $1,000.00
Check
Credit/Debit
Name of Event Requiring Special Permit:
____________________________________
Location of Event Requiring Special Permit:
____________________________________
____________________________________
Date(s) of Event Requiring Special Permit:
____________________________________
Total Number of Guards work under permission the Special Event Permit:
_________
Attestation:
I attest that the company complies with the requirements to provide security under the provisions of this Special
Events Security Permit as specified by Tennessee Code Annotated § 62-35-105(d) and in Tennessee Comp. R. &
Regs., Chapter 0780-05-02, as adopted.
I attest that the attached Excel spreadsheet lists all personnel working the special event for which this permit is
granted.
Board: 3703 Contract Security Company
Transaction: _______ Event Permit
REQUEST FOR SPECIAL EVENT PERMIT
All information must be typed or legibly printed and all questions must be answered. Submit request and a non-
refundable application fee of one thousand dollars ($1,000.00) payable to S
T
via electronic check and/or
TATE OF
ENNESSEE
credit/debit card.
Contract Security Company: ____________________________________________________
Contract Security Company License Number: __________________
Fee: $1,000.00
Check
Credit/Debit
Name of Event Requiring Special Permit:
____________________________________
Location of Event Requiring Special Permit:
____________________________________
____________________________________
Date(s) of Event Requiring Special Permit:
____________________________________
Total Number of Guards work under permission the Special Event Permit:
_________
Attestation:
I attest that the company complies with the requirements to provide security under the provisions of this Special
Events Security Permit as specified by Tennessee Code Annotated § 62-35-105(d) and in Tennessee Comp. R. &
Regs., Chapter 0780-05-02, as adopted.
I attest that the attached Excel spreadsheet lists all personnel working the special event for which this permit is
granted.
SPECIAL EVENT SECURITY PERMIT - TEMPORARY SECURITY GUARDS
NAME (Last, First)
Address
Date of
Social Security
Licensed in
If yes, state and
Birth
Number
another
license number
jurisdiction
(Yes, No)
1
2
3
4
5
6
7
8
9
10
11
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