Peddler Permit Application
VILLAGE OF FULTONVILLE PEDDLER PERMIT
APPLICATION
Applicant:
Business Name:
Federal ID Number:
Home Address:
Cell number: Home:
Age: Social Security Number:
The undersigned hereby
makes application for a permit to carry on the business of PEDDLER OR HAWKER.
Circle one: With Automobile Hand Cart On foot w/o wheeled Vehicle
Within the Village of
Fultonville subject to the provisions of the Village Code.
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Goods to be sold:
Vehicle Description (if
applicable):
Year, make and color:
License plate number:
Serial number:
Insurance Company:
Policy number: (
Attach a copy of insurance card)
Business owner:
Business ID number:
Home Address:
Home phone: Business phone:
Business Address:
Operator Name:
Address:
Driver License number: (Attach copy of License)
Business Ownership: Is
Applicant owner? YES NO
If No: Owner name:
Home Address:
Business Address:
Home phone: Business phone:
List all home addresses
for the owner, applicant, and/or sellers of goods drivers for the past ten (10)
years on a separate sheet of paper.
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Has the owner ever been
convicted of a crime? YES NO.
Has the driver(s) and/or
sellers ever been convicted of a crime?
YES NO.
Has the applicant ever
been convicted of a crime? YES NO.
Have owner, applicant,
drivers and/or sellers ever been arrested?
YES NO.
Explain
all affirmative answers:
Fee: $40.00 Paid:
check cash Date:
APPROVED:
DENIED:
DENIAL REASON:
Code Enforcement Officer:
Date:
9/30/2022 8:46:53 AM