Transient Merchant Registration

Pursuant to Madison General Ordinances, Section 9.17. Fee: $50 (Non-Refundable).

Office Use:

License # __________

Date Application Filed __________

Date License Issued __________

Section 1: All Applicants

Applicant shall present to the Clerk photocopies of the following items for examination:

‫ ٱ‬Wisconsin State Seller’s Permit (if applicable)

‫ ٱ‬One of the following photo identifications for background check: State Driver’s License, State ID,

Federal ID, or Green Card

‫ ٱ‬State certification of examination and approval from the sealer of weights and measures (where

applicant’s business requires use of weights and measuring devices)

1. Name of Individual, Partnership (list all general partners), Corporation, or Limited Liability Company:

__________________________________________________________________________________________

Permanent Address _______________________________________ City/State/Zip ______________________

Temporary Address _______________________________________ City/State/Zip _____________________

Permanent Phone # ____________________________ Temporary Phone # ___________________________

2. Name, address and telephone number of person, firm, association or corporation that the transient merchant

represents, is employed by, or whose merchandise is being sold:

Name __________________________________________________________ Phone _____________________

Address____________________________________________________________________________________

City ____________________________ State _____________________ Zip Code _______________________

3. Temporary address and telephone number from which business will be conducted, if any:

Address_________________________________________________________ City ______________________

State _____________________ Zip Code _______________________ Phone __________________________

4. Nature of business to be conducted and a brief description of the merchandise and any services offered:

__________________________________________________________________________________________

5. Proposed methods of delivery of merchandise, if applicable: __________________________________________

__________________________________________________________________________________________

6. Vehicle(s) to be used in Madison during conduct of business:

Make

Model

Year

License Plate Number

7. Last three cities, villages, and/or towns where applicant conducted business:

City/Village/Town

Address

8. Place(s) applicant can be contacted for at least seven days after leaving Madison.

____________________________________________ Phone Number(s) ______________________________

Transient Merchant Registration - Wisconsin