Vendor/Peddler Application Vendor/Peddler Application $100 fee required with application – must provide copy of a valid Driver's License and car registration. Date of Submission * Applicant's First Name * Applicant's Last Name * Company Name Permanent Home Address * Town/Hamlet * State * Zip Code * Full Local Address (If different from above.) Applicant's Phone * Applicant's Email Driver's License Number * State * Date of Birth * Vehicle Year * Vehicle Make * Vehicle Model * If employed, provide the name and address of the employer, together with credentials establishing the exact relationship: The place where the merchandise or services to be sold or offered for sale are manufactured or products, where such merchandise is located at the time such application is filed and proposed method of delivery: * Dates to Conduct Vending * Property Owner * Phone Number * Location of Property where merchandise/service to to be sold * Two business references located in the County of Sullivan, State of New York, or in lieu thereof, such other available evidence of the character and business responsibility of the applicant as will enable an investigator to properly evaluate such character and responsibility: * Have you ever been convicted of any crime, misdemeanor or violation of any manicipal ordinance and the nature of the offense and punishment or penalty assessed therefore: * Signature of Applicant (Print this form and sign in front of Notary.) Printed Name of Applicant * Sworn to before me on this day: Notary Signature of Applicant Captcha Print and notarize. If you are human, leave this field blank.
