Fee: $1,000.00

ITINERANT VENDOR LICENSE
APPLICATION FORM


APPLICANT DETAILS

Applicant Name: *
Applicant Email:

Phone Number:

Address of Applicant: *
City: *
State:*
The undersigned hereby makes application for a license to sell merchandise at
Date of Sale: *
Time of Sale:
HH:
 MM:     

The undersigned also declares the following:

The number of days proposed to engage in business: *
The location of the merchandise:*
Are goods on the premises from which they are to be sold, or in a warehouse or storage?: *

Names and residences of the owners or persons in whose name the sale is conducted:

An accurate estimate of the average quantity,
type and value of the goods intended or exposed for sale: *

Quantity :

Type:

Value:

The names and post office addresses of the persons from whom the goods were or are to be purchased:

Please enter the verification
code in the box: *
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