Second Hand Dealer Daily Report
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Business Name  Your Name 
Business Address 
Business Phone # 
 
Business Name  Your Name 
Business Address    Date of Report 
Business Phone # 
No Reportable Activity  

Inventory # Time of Sale Amount Paid Full Description of Item Model # or Style Makers Name Identifying Numbers Size ID (Confirmed?) Customer Information
Inventory # Time of Sale Amount Paid Full Description of Item Model # or Style Makers Name Identifying Numbers Size ID Customer Information

The above is a true description of ALL property bought or taken in by the above stated business on the above stated date.

I understand that in submitting this form I am filing a business record as required by Article XII of the Ordinances of the City of Elmira.

I understand that any false information, omissions to this form may result in prosecution for any applicable City of Elmira or New York State statute.

Notes (Optional)


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