Peddling / Soliciting Licensing Application

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Choose the Application Type:

General Vendor Ice Cream/Food Vendor Transient Retail Merchant

Applicant Email Address *

Peddling / Soliciting Licensing Application

The undersigned hereby applies to the Board of Commissioners of Springfield Township for a Peddling/Soliciting License for the balance of the current calendar year and under the same proposes to sell the following:

License Number

Date Issued

Application Type *

Fee

Goods or Services to be Sold *

Supplier's Name *

Supplier's Address *

City *

State *

Zip Code *

Applicant's Name *

Applicant's Address *

City

State *

Zip Code *

Telephone Number *

Driver's License Number *

Have You Ever Convicted of a Crime? *

Yes No

Describe Details *

Make of Vehicle to be Used *

Model of Vehicle to be Used

Make of Vehicle 2

Model of Vehicle 2

Make of Vehicle

Model of Vehicle 3

Make of Vehicle 4

Model of Vehicle 4

License Plate Numbers *

License Plate Number 2

License Plate Number 3

License Plate Number 4

Number of Vehicles to be Used *

Number of Persons Employed *

Attach Copy of Photo ID

Upload

Attach Copy of Current Background Check

Upload

AND FURTHER, the undersigned hereby affirms that the above information is true, correct and complete.

Applicant's Signature

Peddling / Soliciting Licensing Application

Food Vendor

The undersigned hereby applies to the Board of Commissioners of Springfield Township for a Peddling/Soliciting License for the balance of the current calendar year and under the same proposes to sell the following:

License Number

Date Issued

Goods or Services to be Sold *

Supplier's Name *

Supplier's Address *

City *

State *

Zip Code *

Applicant's Name *

Applicant's Address *

City *

State *

Zip Code *

Telephone Number *

Driver's License Number *

Have You Ever Convicted of a Crime? *

Yes No

Describe Details *

Make of Vehicle to be Used *

Model of Vehicle to be Used *

Make of Vehicle 2

Model of Vehicle 2

Make of Vehicle

Model of Vehicle 3

Make of Vehicle 4

Model of Vehicle 4

License Plate Numbers *

License Plate Number 2

License Plate Number 3

License Plate Number 4

Number of Vehicles to be Used *

Number of Persons Employed *

Fee

Food Fee Amount

AND FURTHER, the undersigned hereby affirms that the above information is true, correct and complete.

Applicant's Signature

Peddling / Soliciting Licensing Application

Mall Retailer

The undersigned hereby applies to the Board of Commissioners of Springfield Township for a Peddling/Soliciting License for the balance of the current calendar year and under the same proposes to sell the following:

License Number

Date issued

Goods or Services to be Sold *

Supplier's Name *

Supplier's Address *

City *

State *

Zip Code *

Applicant's Name *

Applicant's Address *

City *

State *

Zip Code *

Telephone Number *

Driver's License Number *

Have You Ever Convicted of a Crime? *

Yes No

Describe Details *

Number of Days at Location

Fee

AND FURTHER, the undersigned hereby affirms that the above information is true, correct and complete.

Applicant's Signature

Payment Information

Payment of fees for this application will be requested via email once your submission has been reviewed.  Please verify that emails from donotreply@springfielddel.co are not sent to your spam/junk mail folder.  The email will contain a link to this form allowing you to make a secure payment by credit card.  The amount shown below is an estimated amount and may be adjusted once your submission is reviewed.

Applicant Name

Payment Amount Due

Peddling / Soliciting Licensing Application

Peddling / Soliciting Licensing Application

Peddling / Soliciting Licensing Application

Food Vendor

Peddling / Soliciting Licensing Application

Mall Retailer

Payment Information

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