Type Full Name :
Sign With Hand
State*
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Please list the names and full addresses of personal references. A minimum of two references are required for consideration of a Peddler's License.
Event Information
Number of Vehicles to be Operated
Your Town, USA 00000
* Indicates required field
First Name*
Personal References
Date of Event*
Address*
Describe the wares you propose to sell*
Telephone #*
Applicant Signature
The fee for a Peddler's License is assessed at $25.00 per day or $100.00 for an annual license.
(555) 555-5555
State*
Your Town
Address*
City*
Number of Days Applied for
Firm Name*
Applicant Information
The above named applicant hereby makes application for Peddler's License and agrees to abide by and be bound by the terms and conditions of an ordinance entitled "An Ordinance to license hawkers, peddlers, transient merchants, itinerant vendors, solicitors and new merchants in Your Town; repealing all inconsistent ordinances, "adopted November 29, 1933, as amended and supplemented.
www.yourtown.gov
Use the "+Add New Record" button below to add each Name and address and click Update to save.
Zip*
Have you been arrested or convicted of a crime or misdemeanor?
Last Name*
City*
Previous Addresses
Application for Peddler's License
Fee Due
Please list the names and full addresses of all dealers / suppliers from whom you purchase wares to sell.
Dealers/Suppliers Details
Number of Assistants
Zip*
123 Main Ave
Please list all places of residence for the past three (3) years.
Firm Being Represented
Use the +Add New Record button below to add each Name and address and click Update to save.
If "Yes", please describe the misdemeanor or crime.
Email*
Fee Schedule