7 Cloutman Street REQUEST FOR LEGAL NOTICE (1) ITHE SALEM NEWS
REQUEST FOR LEGAL NOTICE
Payment is required at the time of the legal notice being received by the city and before it is _rredshed in
the newspaper.An email will be sent to you with the cost. Pavm�t by c --
Prepaid cost required to run the ad:$540. $270 per day x two(2)days=$540
***Imp9rtant:Average legal notice costs are estimated;customers paying by check will be refunded if the
legal ad is less than the deposit amount.
If paying by check,please make checks payable to THE SALEM NEWS and mail to:
City of Salem
Dept.Of Planning and Community Development
Cc:ZBA
98 Washington St
2°°Floor
Salem,MA 01970
Please choose and check one of the boxes for payment option:
C✓Check# / v (attach check)
OCredit Card—Must call Salem News legal notice clerk at 978-675-2710
If payment is not received,the legal notice may be cancelled.
I understand that by signing this form,I am agreeing to the cost of the legal notice to be published in the
newspaper.
Signed Applicant/Aut orized Agent
Print Name: Pue,r—rk E"�ey -j�70y- go V'1 ov)0:1,0
Address: / 'f Ea , )25 IQ-oz,-'-1
l e )j Lw, ,"-; L, VO k 0188?
Email: 00e-flk10 a mceil .Cow,
Phone:
Date: 17 c-- V r-4-5-
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