Peddlers and Canvassers Permit Application

License Application for - Peddlers and Canvassers

MUNICIPAL CODE SECTION – 4-43
South Bend Municipal Code: Section 4-43

Definition:

A peddler is one who sells or offers tangible commodities for sale directly to a consumer from house to house, store to store, or on the streets. Peddlers shall include persons selling from any type of motor vehicle; persons going on foot as "pack peddlers." A canvasser or solicitor is one who takes orders for future deliveries of goods or services in public or private places or from house to house and not from an established place on private premises.

IF DESCRIPTION DOES NOT APPLY, SEE:

Food Vending Vehicle (§4-25)

Restaurant (§§4-45 & 4-46)

General Instructions
1. Assemble all required information and materials before filing application.
2. Thoroughly review all applicable Municipal Code Sections listed above.
3. Licenses expire January 31.
4. Add 10% to license fee for renewal after expiration date.
5. Include $5.00 license application fee payable to City of South Bend.
6. License fee payable to City of South Bend due at issuance - $50
7. If applicant resides outside the South Bend city limits, they will need to complete a background check form.
Required Information and Materials
1. Vehicle / Driver's License State and Number and VIN (if applicable).
2. Weights and Measures Sealer Certificate (if applicable).
3. Copy of a State Issued ID or Driver’s License.
Application Process
1. Submit Application with $5.00 Processing Fee.
2. Police Review and Recommendation to City Controller including Criminal / Traffic Record and Public Health, Safety and Welfare issues.
3. Controller Denies or Approves License (May require personal or surety bond).
4. License issued upon approval and payment of the license fee.
5. License Holder may do business with properly displayed badge, tag, plate, or sign.
6. Replace Lost/Destroyed License $5.

Application Type
Is this application pertaining to a new business or are you renewing your existing permit?*

New PermitRenew Permit
Business Data
Peddler's/Canvasser's Name

First NameLast Name
Name of business you are representing*
Business Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Business Email Address*
example@example.com
Supervisor's Name

First NameLast Name
Supervisor's Telephone Number
Please enter a valid phone number.Format: (000) 000-0000.
Type of Goods, Wares, Merchandise to be sold, or Future Deliveries of Goods or Services
Proposed dates of operation
Locations where Applicant intends to do business
Peddling/Canvassing will take place

On FootPushcartWagonVehicle

Will the food be sold by weight or measure?*

YesNo
Upload certificate from the Sealer of Weights and Measures.

Cancelof
Personal Data
Applicant's Legal Name*

First NameMiddle NameLast Name
Residential Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant Home Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Applicant Cell Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Applicant Email*
example@example.com
Position with Business*
Last Four Digits of Applicant's Social Security Number
Copy of Applicant's Driver's License or other government-issued ID

Cancelof
Applicant's Race
Applicant's Gender
Is the Applicant an honorably discharged veteran?

YesNo
Attach copy of your DD214 papers

Cancelof
Has the Applicant been convicted of a felony?

YesNo
Does the Applicant have a police record?

YesNo
Has the Applicant been convicted of any misdemeanors or violations of any city ordinance?

YesNo
If yes to any of the above, describe the nature of offense(s) and punishment or penalty assessed (other than for traffic violations).
Signature
I, hereby, certify and affirm that all the information I have given in this application is true and accurate to the best of my knowledge. I further certify that I have in no way attempted to mislead the City in this application by omitting facts known to me. I have read and understand the regulations of the Peddlers and Canvassers license found in the City of South Bend Municipal Code, Section 4-43
Electronic Signature*

First NameLast Name
Date*

MonthDayYear
Should be Empty:

Rows	Input information here.
Vehicle License Number
License Plate State
Vehicle Identification Number (VIN)
Owner's Driver's License Number
Owner's Driver's License State
Make and Model of Vehicle

License Application for - Peddlers and Canvassers

Definition:

General Instructions

Required Information and Materials

Application Process

Application Type

Business Data

Personal Data

Signature