City
Business Location
State
Suite/Unit #
ZIP
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Address
{[PNAME]}
Search for the business address and select it from the drop-down, or select the Non Resident or Address Not Found option.
  • Business Details
  • Contacts
  • Release of Criminal Information
  • Attachments
  • Certification
Phone #
Location Scrap will be disposed of, sold, or stored
Timeframe
State License #
Registration Type
Pushcart Type
If you are applying for a Business Registration License skip to the next page. If you are applying for another type of license, please complete the fields below that correspond to the license in which you are applying.
Thank you!
Transient Merchant License:
Ownership Type
Illinois State Tax #
Name
Business Details
Scrap Dealer License:
Location and Dates for which the license is requested:
Federal Tax ID
License Type
Admission Price (If any)
Describe the nature of the Business, including types of products to be sold, services provided, or activities to be conducted.
Nature of Goods, Wares, or Merchandise to be sold or offered for sale:
Have you previously applied for a Transient Merchant License in the last 12 months?
Push Cart License:
Email
# of days (Max. 6)
Address
Owner same as Applicant?
Last Name
Email
First Name
State
Address
State
Mailing Address
Email
Registered Agent Details (Corporations Only)
State
Phone #
Last Name
Phone #
City
ZIP
Business Owner Details
Applicant Details
Contact Name
City
Phone #
First Name
City
ZIP
ZIP
Email
Have you ever been convicted of a criminal offense under this name or any other name?
Drivers License #
Date of Birth
Social Security #
Release of Criminal Information
If "Yes", list offence, date of conviction, and place where convicted:
If you are requesting another type of license, please attach any of the following documents that apply:

1) Copy of your State License.
2) Certificate of Liability Insurance.
3) Site plan, floor plan, or sketch of the property or building premises.
If you are applying for a Business Registration License you may skip this page and click Next.
Attachments
Type Full Name :
Sign With Hand
I hereby agree to operate the above-described business in accordance with all regulations and conditions imposed by all Federal, State, and Local laws. I understand that any false statement could result in the revocation or denial of license.
Amount Due
Estimated Fees
Certification
Applicant Signature