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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. The application is online only. Payment is check or cash. The application will sit in a queue until payment is received. Any applications without payment within 7 days are considered rejected.
4. First Name*
5. Middle Name*
6. Last Name*
8. Permanent Address*
10. Phone Number*
11. Driver License Upload*
    This photo will be used for your license.
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. $500.00 Surety Bond Upload
    ONLY if the applicant is not a Waukesha County resident or represents a firm whose principal place of business is located outside of the State.
49. Food License Permit
    ONLY if selling food. This license will come from the County or State.
51. Email Address(s) for License to be Sent*
    License must be PRINTED AND VISIBLY WORN while walking around the Village. Failure to do so will cause an automatic cancellation of the license.
53. 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.
54. Charitable Organization Upload
56. Acknowledgement
    By submitting this document electronically, 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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58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit

* indicates a required field