City of Byron - Peddler/Solicitor's License

APPLICATION FOR PEDDLER/SOLICITOR’S LICENSE
Business Information
Business/Company Name*
Proposed Activity and Date/Times*
Permanent Business Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Business Phone*
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Supervisor Name*

First NameLast Name
Applicant Information
Applicants Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Phone Number*
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Email*
example@example.com
Place of Birth*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Driver's License Number*
State Issued*

Street Address

Street Address Line 2

CityState / Province

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Home Number*
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Cell Phone*
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Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vehicle Information
Motor Vehicle will be used? (If yes, list vehicle information)*

YesNo
Vehicle Year
Make
Model
Color
License
State
Insurance Company Name
Policy Number
(Must show proof of insurance if vehicle will be used)
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THE RESIDENTS OF BYRON ARE GIVEN THE OPPORTUNITY TO COMPLETE A "NO SOLICITATION FORM' THIS FORM FORBIDS PEDDLERS/SOLICITORS FROM THEIR PROPERTY WHETHER THE PEDDLER/SOLICITOR HAS BEEN ISSUED A PERMIT FROM THE CITY OF BYRON OR NOT. IF YOU DO GO TO THOSE RESIDENTS, YOU MAY BE ISSUED A CITATION AND FINED.

I HEREBY STATE THAT THE ABOVE INFORMATION IS TRUE AND CORRECT. I UNDERSTAND THAT FAILURE TO COMPLY WITH THE CITY OF BYRON ORDINANCE WILL CONSTITUTE SUSPENSION OR REVOCATION OF THIS PERMIT.
Applicant's Signature*

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Date*

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APPLICATION FOR PEDDLER/SOLICITOR’S LICENSE

Business Information

Applicant Information

Vehicle Information