Fillable Solicitor Peddler Application

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Solicitor Peddler Application

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The Solicitor Peddler Application form is 1 page long and contains:

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  • 10 check-boxes
  • 41 other fields

Country of origin: US
File type: PDF

U.S.A. forms for Village of Lincolnshire

BROWSE VILLAGE OF LINCOLNSHIRE (IL) FORMS

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1 Olde Half Day Road, Lincolnshire, IL 60069
www.lincolnshireil.gov
P: 847-913-2350
F: 847-883-9909
Page 1 of 1
Initial Application
$50 Application Fee
Renewal Application
$25 Application Fee
Vest/ID Deposit $50
SOLICITOR/PEDDLER PERMIT
APPLICATION
OFFICE USE ONLY
Permit #:
ORGANIZATION
Peddling / Soliciting for – Product or Service
End Date
Type of Application
Individual Group
Type of Organization (Check all that apply)
Commercial Not-for-Profit Charitable
Date of Application
Name of Organization
Date(s) of Previous Application
Organization Address
City
State
Zip Code
Contact Person
Title
Contact Person Phone #
Illinois Charitable Organization
Registration #
Illinois Number – Illinois Attorney
General IL-
Lincolnshire Organization
Type of Peddling / Solicitation
Door-to-Door On-Street Solicitation/Peddling
On-Street Location
Has Organization been previously prohibited
from soliciting? Yes No
Date of Action
Location(s) Prohibited
APPLICANT INFORMATION
Solicitor/Peddler Name
Date of Birth
Telephone #
Address
City
State
Zip Code
Driver’s License/ID #
DL State
Vehicle Type
Vehicle Registration
Reg State
Previous Address (Last Three Years)
Previously Issued Solicitor Permit?
Yes No Date:
Applicant Previously Convicted of a Felony?
Yes No
Date of Conviction/Charges
Previously Charged with Solicitor/Peddler Violation?
Yes No
Date/Location of Violation
If Youth Organization Group Permit, include list of names of all people who will be soliciting.
I certify that all of the statements above are true and correct, and I understand and authorize a criminal
records check. I understand the Permit and Issued Vest must be returned within 5 days of the permit
expiration for refund of my deposit.
Signature ____________________________________ Date ___________________________
DO NOT WRITE BELOW THIS LINE - OFFICE USE ONLY
Permit
Dates
to
Fee Paid
Approved
Denied
Received By
Date
Processed By
Date
Fingerprinted
By
Date
CQH
Returned
Negative Positive
Approved
By
Date
Vest and Permit
Refund Due Date
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Solicitor Peddler Application

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Completed 13 July 2020

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