Town of Sheffield
Chartered 1793

37 Dane Road
PO Box 165

Sheffield, VT 05866-0165

 

Application for Exemption to Mandatory V.A.S.A. Membership of the Snowmobile ATV Ordinance under Section IV, ยง G, article 1

I _________________________________ exclusively use ______________________________________________________
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Traveling from and to ______________________________________________________
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and hereby request that an exemption from the requirement for V.A.S.A. membership be granted to me by the members of the Sheffield Select Board.

 

I understand that, if granted, this exemption may be withdrawn at any time with or without stated cause and any certificate of exemption issued must be immediately surrendered to the Sheffield Select Board or its duly authorized agent.

 

I, the undersigned, do attest that the signature below, whether written and/or printed, constitutes my legal and binding signature.

 

Signed,

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