PEDDLER APPLICATION

BOROUGH OF HOPEWELL
PO Box 128, 4 Columbia Avenue

Hopewell, NJ 08525
Tel: 609-466-2636 Fax: 609-466-8511


Application For Peddlers, Solicitors, Hawkers, or Transient Merchants


PLEASE PRINT OR TYPE

NAME OF APPLICANT________________________________________________________________
First Middle Last

ADDRESS___________________________________________________________________________
STATE____________________ZIP ____________ TELEPHONE (___)____________________

E-MAIL ________________________________________CELL PHONE ( )_____________________

LOCAL ADDRESS (if different from home address)

__________________________________________________STATE_____________ZIP_____________
DATE OF BIRTH______/______/_____SOCIAL SECURITY NUMBER_______________________
Month Day Year
DRIVER’S LICENSE mos_______________________________________________________________________
STATE OF ISSUANCE___________________________________
NAME OF ORGANIZATION__________________________________________________________
ADDRESS_______________________________________________STATE_________ZIP________
TELEPHONE (____)___________________

BRIEF DESCRIPTION OF MERCHANDISE BEING SOLD OR DISTRIBUTED:

_____________________________________________________________________________________

LIST ALL VEHICLES TO BE UTILIZED (Attach separate sheet if necessary)
MAKE MODEL LICENSE PLATE NO. STATE OF ISSUANCE
1.

2.

SIGNATURE OF APPLICANT_____________________________________DATE__________

FOR OFFICE USE ONLY
APPROVED BY:

POLICE DEPARTMENT_________________________________________DATE_________
BOARD OF HEALTH (if applicable)________________________________DATE_________
ZONING OFFICER (if applicable)__________________________________DATE_________
LICENSE mos_____________ DATE ISSUED________________