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2. First Name*
3. Last Name*
5. Email Address*
6. Phone Number
8. Street Address*
10. Zip Code*

11. The decal(s) will be mailed to the Puyallup address provided.

13. Number of decals requested:*
14. Upload proof of registration.*

    Upload a copy of each vehicle registration containing the address of the property located within the 4 hour parking zone. 

    **Two vehicles per residence may have a twenty-four hour per day parking decal.

    
    

16. Certification

    By signing this, I certify that I have read this application and declare under penalty of perjury that the information contained herin is correct and complete. 

17. Acknowledgement*

    1. I agree.
19. 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.
21. Electronic Signature*
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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit

* indicates a required field