Peddlers Permit

APPLICATION FOR PERMIT FOR PEDDLERS, CANVASSERS, AND SOLICITORS
Name:*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Height:*
Weight:*
Hair Color:*
Eye Color:*
Drivers License Number:*
Drivers License Photo:*

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Social Security #:*
Phone:*
Email*
example@example.com
Permanent Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Address in City of Mount Pleasant:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Kind of goods or business (Description)*
Name of Employer:*
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Credentials must be furnished from employer establishing the exact relationship:*

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How long do you wish to do business?*
Names and address of two reputable local property owners who will certify as to moral reputation and business responsibility (if not available, other evidence as to the moral reputation and business responsibility must be furnished:*
Have you been convicted of any crime or misdemeanor or for violating any municipal ordinance? If Yes, give details as to the nature and penalty or punishment:*
Name last three cities or towns where you carried on business immediately preceding the date of this application. Furnish address from which business was conducted in these cities or towns:*
A recent, clear photograph must be furnished at least two (2) inches square showing head & shoulders.*

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A fee of $100.00 per calendar year or $10.00 per day shall be paid to the City of Mount Pleasant upon the filing of this application. This is to cover the cost of issuing the permit and investigating the facts stated herein.
Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

APPLICATION FOR PERMIT FOR PEDDLERS, CANVASSERS, AND SOLICITORS