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) ______________________________