Golf Cart Renewal Permit Application
City of Effingham, 201 E. Jefferson Ave., Effingham, IL 62401
October 1, 2024 - September 30, 2025
Purpose: This application is for a permit sticker to operate a “Golf Cart” on City of Effingham Streets and Alleys in accordance with City of Effingham Ordinance No. 057-2022 for the year beginning October 1, 2024 through September 30, 2025. I certify that by signing this permit the golf cart is the same as inspected in 2023-2024 and all required equipment is in working order (see attached checklist). I agree to follow all rules in operating the cart on City Streets and Alleys and if stopped for any reason the Officer may choose to do a complete inspection and if the driver is in violation of the ordinance a fine will be imposed. Stickers must be placed on the rear on passenger side like in previous years.
Applicant Information:
Name
*
First Name
Middle Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Birth Date
*
Please select a month
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Year
Primary Phone Number
*
Please enter a valid phone number.
Other Phone Number
Please enter a valid phone number.
Driver's License Number
*
Driver's License Expiration Date
*
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Golf Cart Information:
Old Permit Number
*
Make
*
Model
*
Color
*
Serial Number
*
Number of Seat Belts
*
Sticker Fee: $50.00 ($40.00 for ages 62 years and older)
To be paid in person at the Effingham Police Department on or after September 27, 2024
Payment
Cash
Money Order
Check
If paying by check, what is your check number?
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Golf Cart Checklist - Renewal Application
City of Effingham, 201 E. Jefferson Ave., Effingham, IL 62401
Please review the following checklist for all mandatory equipment necessary to obtain a renewal permit:
*
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Please upload a photo of your current driver's license.
*
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Please upload a copy of your current liability insurance policy as required under 625 ILCS 5.0/7-601, specifically for vehicle to be operated within the City of Effingham:
*
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Please upload a copy of your original executed Unconditional and Full General Release of Liability, Waiver, Discharge, and Covenant Not to Sue:
*
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Get help
Please see the City of Effingham’s website at www.effinghamil.com to review the complete Golf Cart ordinance (057-2022). A map of the city and all allowable golf cart routes and crossings can also be found on the website. You may also contact Effingham Police Department Records for more information at EPD@EffinghamIL.com or call 217-347-0774 extension 5326. To complete the application process and receive your permit sticker, please bring a check, money order or cash to Effingham Police Department, 110 S. 3rd Street, Effingham, IL 62401 weekdays between 8:00 a.m. and 4:00 p.m.
Please verify that you are human
*
Signature
*
Submit
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