Data Loading...
SOLICITING, CANVASSING AND PEDDLING PERMIT Flipbook PDF
city of west burlington soliciting, canvassing and peddling permit a separate application is required for each person pr
105 Views
49 Downloads
FLIP PDF 238.23KB
City of West Burlington
SOLICITING, CANVASSING AND PEDDLING PERMIT A SEPARATE APPLICATION IS REQUIRED FOR EACH PERSON PROPOSING TO SOLICIT, CANVAS OR PEDDLE WITHIN THE CITY LIMITS OF WEST BURLINGTON
APPLICANT INFORMATION
CITY USE ONLY
Applicant Name:
_____ Approved
Applicant Permanent Address: _______________________________________
_____ Denied
City:
State: _____Zip Code: ________
Date: _____________
Social Security No.: _____________________ Date of Birth: ______________
Signature:
Drivers License No. & State of Issue: __________________________________ (must have drivers license or photo id present for copying)
_____________________________ POLICE CHIEF
BUSINESS INFORMATION Business Name: Mailing Address: City: Phone: (
State: _____Zip Code: ________ )
Email: _____________________________________ Fax: (
)
___
What type of business are you conducting? ________________________ _________________________ Explain wares, goods or merchandise to be sold or offered for sale: ______________________________ ________________________________________________________________________________________ * Provide copy of any literature you will be distributing. Are you authorized as a business to operate in Iowa? ________Iowa Sales Tax Permit # _________________ List the dates and times you will be conducting business: Note: Door to door peddling or soliciting is permitted Monday through Saturday only and may only be done between the hours of 9:00 a.m. and 5:00 p.m. Dates:
Hours:
Dates:
Hours:
Dates:
Hours:
VEHICLE INFORMATION Complete the following information for each vehicle to be used while engaging in peddling or soliciting. Include a copy of registration and insurance certificates.
YEAR
MAKE
COLOR
LICENSE PLATE NO.
Business Name: Mailing Address: City:
State: _____Zip Code: ________
ARREST INFORMATION List any arrests for consumer fraud or theft and the location of arrest.
* If not a West Burlington Resident, attach a letter from the Chief of Police or Sheriff where your permanent address is located, listing any arrest for consumer fraud or theft and the location. If not a US resident, attach VISA paperwork SIGNATURE Applicant Signature:
____
Print Name: ______________________________________
Date:
PEDDLER OR SOLICITORS PERMIT REQUIREMENT Applications must be submitted to the City Hall, West Burlington City Hall, 122 Broadway St., West Burlington, IA 52655 The following information must be submitted with your completed application: 1. Copy of Literature you will be distributing 2. Copy of Drivers License or Photo Identification 3. Copy of Tax ID # 4. Copy of Vehicle Registration and Insurance Certificate for each Vehicle being used while peddling or soliciting 5. If not a West Burlington Resident, attach a letter from the Chief of Police or Sheriff where your permanent address is located, listing any arrest for consumer fraud or theft and the location. If not a US resident, attach VISA paperwork.