Type Full Name :
Sign With Hand
Give a detailed description of Goods to be Sold
Insurance Policy #
{[CITY]}, {[STATE]} {[ZIP]}
Previous Residence(s)
Last Name *
Has the Applicant ever been convicted of a crime?
City *
Phone # *
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Please provide the following with this application:

  • A list, on Company letterhead, of the names and addresses of the persons engaging in the canvassing, soliciting or itinerant vending.
  • The names and addresses of the individuals or companies by which such persons are employed.
  • A list, on company letterhead, of any motor vehicle to be used including the make, model, color, License plate number, and all insurance information, including name and address of the carrier, policy number and type of coverage
  • A listing of the street or streets in Jackson Township in which the canvassing, itinerant vending or soliciting will take place, including the starting and ending dates, and time of day for such solicitation.
  • Proof of an insurance policy (i.e., Acord form) issued by a NJ licensed Company protecting the applicant and the Township from all claims or damages to property and bodily injury, including death, which may arise in connection with the applicant's vending business activities. Said policy shall name the Township of Jackson as an additional insured and shall provide that the policy may not be terminated prior to the expiration date without at least 30 days' advance written notice to the Office of the Township Clerk. Minimum amounts of insurance coverage are: a) Personal Injury $100,000 per person/$300,000 per occurrence; b) Property Damage $50,000.
  • Two (2) 1-inch square photos showing the applicant's face (must be a recent photo)

    All itinerant vendors selling goods from a stand or vehicle must also provide:
  • Copy of valid Driver's License
  • Copy of Business Registration Certificate
  • Copy of NJ Sales Tax Certificate of Authority
Make and Model
This notice must be filed with the Township Clerk no less than 14 business days prior to the scheduled start date.

Provided the above notice requirements have been satisfied, the Township Clerk shall issue a permit allowing the canvassing or soliciting to take place. This permit shall be valid for a period not to exceed thirty (30) days from the date of issuance. Once expired, the permit must be renewed following the same notice requirements.

Address *
Phone #
Insurance Company
Business Name *
Provide information for the Owner of the Vehicle
Social Security #
License Fee
Are you a veteran?
Preferred License Delivery Method
Business Type *
First Name *
Has the Applicant ever had an application to conduct a vending business denied or revoked?
Firm Being Represented
Firm Name
Are you the Business Owner? *
Date of Birth
Method of Soliciting
Email *
Business Information
Business Address *
Applicant Signature *
Drivers License #
How do you intend to pay? *
First Name *
Place(s) of Residence (Last 5 years)
If you answered "Yes" to any of the above, describe the conviction(s) and/or application denials. Provide date(s).
Applicant Information
Vehicle Information
Provide information for the Driver of the Vehicle
Are you a US Citizen?
License Plate #
Has the Business Owner ever been convicted of a crime?
Phone #
Application Fee
Last Name *
Choose the type of Goods to be Sold *
State *