City of Gallatin Connie Kittrell
132 West Main Street Gallatin, TN 37066-3244 (615) 451-5895 w ww.gallatintn.gov
Peddlers, Solicitors, Itinerant Venders License Application
Expires: _________________ Hours of Operation: _________________
Business or Organization Name: ___________________________________________________________________________
Business or Organization Permanent Address: ___________________________________________________________
Business or Organization Telephone Number: ____________________________________________________________
Business or Organization Temporary Address and Telephone Number:
_________________________________________________________________________________________________________________
Applicant Name: _____________________________________________________________________________________________
Applicant Address: __________________________________________________________________________________________
Date of Birth: ___________________ Height: _______________ Weight: _______________ Hair Color: ______________
Eye Color: ____________ Driver’s License Number: ___________________ Email: _______________________________
Nature of business to be conducted and brief description of goods or services:
_________________________________________________________________________________________________________________
Proposed method of delivery of goods, if applicable: _____________________________________________________
Dates applicant intends to do business or make solicitations: ___________________________________________
Make, model, complete description and license tag number and state of insurance of each vehicle
to be used to make sales or solicitations, whether or not such vehicle is owned individually by
person making sales or solicitations, by the business or organization itself, or rented, or borrowed
from another business or person:
_________________________________________________________________________________________________________________
List last three (3) previous cities, villages, towns, where applicant conducted similar business:
_________________________________________________________________________________________________________________
City of Gallatin Connie Kittrell
132 West Main Street Gallatin, TN 37066-3244 (615) 451-5895 w ww.gallatintn.gov
Address and telephone number where applicant can for contacted for at least seven (7) days after
leaving the City: ______________________________________________________________________________________________
Have you ever been convicted of any crime within the last five (5) years? Yes No
If yes, list the nature of the violation and the place of conviction:
_________________________________________________________________________________________________________________
Name and telephone number of local manager or representative: ______________________________________
Have you ever had an ordinance violation related to transient business within the last give (5)
years? Yes No
If yes, list the nature of the violation and the place of conviction: _______________________________________
Tennessee Sales Tax Number: ______________________________________________________________________________
Permit Fee Amount: $50.00 per six (6) month period Receipt Number: ____________________________
Solicitor Permit Badge must be worn during any solicitation.
_________________________________________ _____________________________
Signature of Applicant Date
Sworn to and subscribed before me this __________ day of ________________________________, 20_______.
________________________________________
Notary Public
My Commission Expires: _________________________
FOR USE BY CITY OF GALLATIN ONLY
Application is hereby: Approved Denied
_______________________________________
City Recorder
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