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Peddler/Transient Merchant/Canvasser Application

2. LICENSE APPLICATION FOR PEDDLERS, CANVASSERS, & TRANSIENT MERCHANTS
   Non-Refundable License Fee: $75 includes background check. THE FOLLOWING QUESTIONS MUST BE ANSWERED COMPLETELY.

   Non-Refundable License Fee: $75 includes background check. THE FOLLOWING QUESTIONS MUST BE ANSWERED COMPLETELY.

4. First Name*

5. Middle Name*

6. Last Name*

8. Permanent Address*

10. Phone Number*

11. Driver License Upload*

13. Social Security Number*

14. Date of Birth*

16. Business Being Represented*

18. Business Address*

20. Phone Number of Business*

21. Nature of Business*

23. Description of Goods/Services/Solicitations*

25. Method of Delivery of Goods*

26. Area within the Village where business is to be conducted*

28. Vehicle 1 Make

29. Vehicle 1 Model

30. Vehicle 1 License Plate

31. Vehicle 1 Year

33. Vehicle 2 Make

34. Vehicle 2 Model

35. Vehicle 2 License Plate

36. Vehicle 2 Year

38. Vehicle 3 Make

39. Vehicle 3 Model

40. Vehicle 3 License Plate

41. Vehicle 3 Year

43. Have you conducted similar business elsewhere? List the city, village, or town. *

45. Have you (within the last 5 years) been convicted of any crime or ordinance violation related to your business solicitations?*

    1. Yes
    2. No

46. If yes, please give details

48. If your business requires a weighing or measuring device, this application must be accompanied by a certificate indicating that the device’s accuracy has been certified by a scale testing agency. If your business/solicitation involves the handling of food or clothing and if such activity is required to be certified under the law, such certificate must be presented when filing this registration. A Non-Refundable Seventy-five dollar ($75) per person fee must accompany this application; except that charitable organization applicants shall be exempt from the fee provided that such organization is registered under §440.41 Wis. Stats. and provides documentation. A driver’s license or other government issued photo identification will be required when filing this registration.

    If your business requires a weighing or measuring device, this application must be accompanied by a certificate indicating that the device’s accuracy has been certified by a scale testing agency. If your business/solicitation involves the handling of food or clothing and if such activity is required to be certified under the law, such certificate must be presented when filing this registration. A Non-Refundable Seventy-five dollar ($75) per person fee must accompany this application; except that charitable organization applicants shall be exempt from the fee provided that such organization is registered under §440.41 Wis. Stats. and provides documentation. A driver’s license or other government issued photo identification will be required when filing this registration.

49. Charitable Organization Upload

51. Acknowledgement
    I, the undersigned, hereby appoint the Village Clerk of the Village of Elm Grove, whomever holds that office from time to time, as my agent authorized to accept service of process in any civil action brought against me arising out of my sale or service performed by me in connection with my sales or solicitation activities in the Village of Elm Grove. Said Village Clerk is authorized to accept service of process on me only in the event that, after reasonable efforts have been made, said service of process cannot be served on me personally. I do hereby swear that the information I have given in this document is true, correct, and complete.

    I, the undersigned, hereby appoint the Village Clerk of the Village of Elm Grove, whomever holds that office from time to time, as my agent authorized to accept service of process in any civil action brought against me arising out of my sale or service performed by me in connection with my sales or solicitation activities in the Village of Elm Grove. Said Village Clerk is authorized to accept service of process on me only in the event that, after reasonable efforts have been made, said service of process cannot be served on me personally. I do hereby swear that the information I have given in this document is true, correct, and complete.

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53. 1. Receive an email copy of this form.
54. Email address

    This field is not part of the form submission.

55. Submit

* indicates a required field