Peddler and Solicitor Permit Application (fillable)

Supporting Documents

Peddlers Application and Confidential Information Release (31 KB)

Web Links

Town Code: Peddler & Solicitor Law

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Pursuant to Chapter 219 of the Yorktown Town Code

Name: *

Address: *

Date of Birth: *

Driver's License State & Number: *

Phone Number: *

FOR PEDDLERS:

List of Goods & Services to be sold: *

County Health Permit No.:

Veteran's ID No.:

Stationary Location:

Non-Stationary Route to be followed:

FOR SOLICITORS AND CANVASSERS:

Organization Name & Address (if applicable):

Is your organization registered with the NYS Attorney General's Charities Bureau?

YES

PLEASE PROVIDE A SAMPLE OF LITERATURE TO BE CANVASSED WHEN APPROVED FOR PERMIT

Dates of Canvassing:

Times of Canvassing:

Locations of Canvassing: 1.

Locations of Canvassing: 2.

Locations of Canvassing: 3.

BUSINESS REFERENCES:

Reference 1. *

Reference 2.

CHECK BOX FOR APPROPRIATE PERMIT AND FEES (YEARLY)

Fee Schedule (Yearly)

Select One: *

Upon permit approval, submit THREE (3) 1" x 1" PHOTOS taken within one (1) month of this application to the Town Clerk's Office along with the appropriate fee. Fingerprints are required prior to permit approval, with the exception of seasonal permits. Information for fingerprinting may be found on the Town Clerk's Forms and Applications webpage. Please print, have notarized, and return the Confidential Information Release Authorization Form on the Town Clerk's Forms and Applications webpage.

Other information and documents will be required before issuance of a permit. Please contact the Town Clerk's Office at (914)962-5722, ext. 209 for more information.

Peddler and Solicitor Permit Application (fillable)

Supporting Documents

Web Links

Contact Information