Application to Conduct Business
Peddler or Transient Merchant
City of
(1) Full legal name: ______________________________________________________
(2) All other names under which applicant conducts business or to which applicant officially answers:
________________________________________________________
(3) Physical description of applicant: hair color _____________; eye color __________;
height __________________; weight ________________; distinguishing marks /
features ________________________________________________________________.
(4) Full address of applicant’s permanent address:
________________________________________________________________________
Street City State Zip
(5) Telephone number of applicant’s permanent address: __________________________
(6) Full legal name of any and all business operations owned, managed or operated by the applicant, or
for which the applicant is an employee or agent:
________________________________________________________________________
(7) Full address of applicant’s regular place of business (if any):
________________________________________________________________________
(8) Any and all business related telephone numbers of the applicant: ________________
________________________________________________________________________
(9) The type of business for which the applicant is applying for a license: _____________
________________________________________________________________________
(10) Annual or daily license: ________________________________________________
(11) Dates and times applicant intends to conduct business: ________________________
________________________________________________________________________
(12) Address and/or phone number applicant can be reached
while conducting business within the City of
________________________________________________
(13) Location applicant intends to set up business within
the City of
______________________________________________________________________
(14) Has applicant ever been convicted of a felony, gross misdemeanor or misdemeanor for violation of any
state or federal statute of any local ordinance other than traffic offenses? ________________________
If yes, please explain: ______________________________________________________________________
(15) List three most recent locations where the applicant has conducted business as a peddler or
transient merchant: _________________________________________________________________________
(16) Written permission and signature of the property owner or the property owner’s agent for any
property to be used by the applicant (can be on a separate sheet): ______________________________
______________________________________________________________________________________
(17) A general description of items to be sold or services to be provided: _____________
________________________________________________________________________
(18) Driver’s license number or other acceptable form of identification of applicant:
________________________________________________________________________
(19) License plate number, registration information and vehicle identification number for any vehicle to be
used in conjunction with the licensed business and description of the vehicle: _________________________
_______________________________________________________________________________________
License Fee:
$30 per day, $150 annual
Payable to:
City of