Fillable LICENSE APPLICATION FOR - PEDDLERS AND CANVASSERS MUNICIPAL (City of South Bend)

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LICENSE APPLICATION FOR - PEDDLERS AND CANVASSERS MUNICIPAL (City of South Bend)

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The LICENSE APPLICATION FOR - PEDDLERS AND CANVASSERS MUNICIPAL (City of South Bend) form is 3 pages long and contains:

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For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - PEDDLERS AND CANVASSERS
MUNICIPAL CODE SECTION - 4-43
DEFINITION:
A peddler is one who sells or offers for sale tangible commodities 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:
Open-Air Business (Ord. §4-38)
GENERAL INSTRUCTIONS:
1. Print legibly and complete all sections to ensure efficient processing.
2. Assemble all required information and materials before filing application.
3. Thoroughly review all applicable Municipal Code Sections listed above.
4. Licenses expire January 31.
5. Add 10% to license fee for renewal after January 31.
6. Include $5.00 license application fee payable to City of South Bend.
7. License fee payable to City of South Bend due at issuance - $50.00.
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.
1
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - PEDDLERS AND CANVASSERS
MUNICIPAL CODE SECTION - 4-43
I. APPLICATION TYPE Check One: New Renewal
II. BUSINESS DATA
A. Peddler's / Canvasser's Name:
B. Name of Business You Are Representing:
C. Business Mailing Address:
City: State: Zip:
D. Business Telephone Number: Fax Number
E. Business E-Mail Address:
F. Supervisors Name and Telephone Number:
G. Type of Goods, Wares, or Merchandise to be sold:
H. Proposed Dates of Operation:
I. Locations where Applicant intends to do business:
J. Peddling / Canvassing will take place (Check One):
On Foot: Pushcart: Wagon: Vehicle
If Vehicle, please provide:
Make and Model of Vehicle:
Vehicle license plate number and issuing state:
Vehicle Identification Number (VIN):
Driver's license number and issuing state:
K. Scales will be used in business transactions: Yes No
If yes, please attach certificate from the Sealer of Weights and Measures.
For Office Use Only
Application Filed License Fee Paid
Application Fee Paid License Number
Sent to Dept. Badge Number
Police Department Approval Metal Plate Number
Not Approved
Reason
2
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - PEDDLERS AND CANVASSERS
MUNICIPAL CODE SECTION - 4-43
III. PERSONAL DATA
A. Applicant's Legal Name:
B. Residential Address:
City: State: Zip:
C. Residential Telephone Number:
D. Cellphone Number:
E. E-Mail Address:
F. Position with Business:
G. Social Security Number: H. Gender:
I. Date of Birth: J. Race:
K. Honorably discharged veteran: Yes No
If yes, please attach a copy of your DD214 papers.
L. Convictions of Felony: Yes No Police Record: Yes No
M. Convictions of any misdemeanors or violations of any city ordinance: Yes No
N. If yes to any of the above, describe the nature of offense(s) and punishment or penalty
assessed (other than for traffic moving violations).
IV. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION
V. INCLUDE A COPY OF A STATE ISSUED ID OR DRIVER’S LICENSE
VI. AFFIRMATION
I, hereby, certify and affirm that all of 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.
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LICENSE APPLICATION FOR - PEDDLERS AND CANVASSERS MUNICIPAL (City of South Bend)

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Completed 16 July 2020

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