Peddlers, Solicitor or Transient Merchant information – Orange City

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Transient Merchant/Peddler/Solicitor Permit Application

The full transient merchant ordinance information is available here:

Transient Merchants Ordinance

Download the application form

Download the Form

Fill out the online application form

Transient Merchant Application Form Peddlers/Solicitors Application Form

Transient Merchant Permit Applicaiton

Step 1 of 6

16%

If multiple individuals are representing a company, this section should be completed by the supervisor of the group.

Fee Schedule(Required)

Select the Fee Choice for your application

One Day $ 10

One Week $ 25

One Month $75

One Year $500

Company Name(Required)

Address(Required)

Street Address City State ZIP Code

Name of owner/Supervisor

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Orange City Operating Address(Required)

Street Address

Include a site map(Required)

Yes

No

Site Map Upload

Max. file size: 32 MB.

Proof State Sale Tax(Required)

State Tax ID #(Required)

Exemption from State/Federal Tax(Required)

What motor vehicles/trailers will be used in connection with the conduction of business?

Make(Required)

Model(Required)

Color(Required)

License Plate #(Required)

List the last three places you’ve engaged in similar activity- City and State:

Provided Proof of liability insurance with a minimum amount of $1,000,000.00

Insurance Documentation

Max. file size: 32 MB.

Date business will Commence(Required)

MM slash DD slash YYYY

Date Business will Terminate(Required)

MM slash DD slash YYYY

Applicant Signature(Required)

By signing you agree that the above information is complete.

CAPTCHA

PEDDLERS/SOLICITORS PERMIT APPLICATION

Step 1 of 9

11%

If multiple individuals are representing a company, this section should be completed by the supervisor of the group.

Fee Schedule(Required)

Select the Fee Choice for your application

One Day $ 10

One Week $ 25

One Month $75

One Year $500

Company Name(Required)

Address(Required)

Street Address City State ZIP Code

Supervisor Name

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Add additional operator names

Any additional persons who will be operating under this license, which includes their names, date of birth, permanent address and telephone number

Required current photo included per peddler/solicitor(Required)

Max. file size: 32 MB.

Upload a current photo.

Proof State Sale Tax(Required)

State Tax ID #(Required)

Exemption from State/Federal Tax(Required)

What motor vehicles/trailers will be used in connection with the conduction of business?

Make(Required)

Model(Required)

Color(Required)

License Plate #(Required)

List the last three places you’ve engaged in similar activity- City and State:

Have any individuals listed been convicted of a felony or misdemeanor, except traffic charges?(Required)

Yes

No

Conviction Information

Please give the Name, Date, Place of Conviction and nature of crime.

Name(Required)

First Last

Date(Required)

MM slash DD slash YYYY

Place(Required)

Crime(Required)

Provided Proof of liability insurance with a minimum amount of $1,000,000.00

Insurance Documentation

Max. file size: 32 MB.

Date business will Commence(Required)

MM slash DD slash YYYY

Date Business will Terminate(Required)

MM slash DD slash YYYY

Applicant Signature(Required)

By signing you agree that the above information is complete.

Approved or Denied

City office Staff use only

Approved

Denied

Additional Information for Police background investigation. I authorize the City of Orange City, Iowa to check my background to determine suitability for a peddler’s/solicitor’s/transient merchant’s permit. I understand that this includes gathering of information relative to violation(s) of law which resulted in conviction(s). My signature releases other police and civilian agencies, employers, universities, colleges, and military services from liability for supplying background information to the City of Orange City, Iowa. In addition, my signature releases the City of Orange City from liability for any statements, acts, or omissions in the course of the investigation into my background, employment history, health, family, personal habits, and reputation. I understand that I am relinquishing all legal rights and causes of action related to the City of Orange City investigation into my suitability for a permit. I understand that this release may be photocopied and submitted for multiple checks related to this position.

Date(Required)

MM slash DD slash YYYY

Name(Required)

First Last

Date of Birth(Required)

MM slash DD slash YYYY

Address

Street Address City State ZIP Code

Phone(Required)

Number you can be reached at

Last 4-digits SS#(Required)

DO NOT enter your Full Social Security #

Signature

CAPTCHA

City of Orange City
125 Central Avenue SE
Orange City, IA 51041

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