Form Center

Steps

1. Step One This section is complete This section is incomplete
2. OWNER INFORMATION This section is complete This section is incomplete
3. SELLER #1 This section is complete This section is incomplete
4. SELLER #2 This section is complete This section is incomplete
5. SELLER #3 This section is complete This section is incomplete

Step One

This application is being made as*
1. Private Property Operator
1. Ice Cream Truck
Name of Business*
State or Federal FEIN Number*
Location(s) of intended sales*
Business hours (opening and closing for each day)*
Proposed nature of business to be conducted (Include types of goods to be sold)
VEHICLE INFORMATION (Ice cream trucks only)
Make/Model
Color
License Plate
State
Make/Model
Color
License Plate
State
Upload copies of the driver's license for each seller including the owner
Owner DL
Seller #1 DL
Seller #2 DL
Seller #3 DL
Certificate of Insurance*
Shall insure the applicant, owner, and lessee, if any, of the parcel at a minimum amount of $300,000 single limit coverage
Statement from Property Owner*
Statement authorizing you to sell on his or her property through December 31 of the current year
Complete Inventory of Goods*
Vehicle Insurance and Registration
Ice cream trucks only
Electronic Signature Agreement*
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature*
Date*
Once your application has been approved by the City, you will receive a secure link from noreply-pay24x7@openedge.com in which to pay your application fee.
Please choose how you prefer to receive the secure link:*
1. Email
2. Text
Email*
Cell Phone*
The following information must be completed for EVERY PERSON who will be in contact with the public for the purpose of stocking, transporting, delivering and/or selling the goods, wares, or merchandise. Any new individuals added after submission of this application must be submitted to the City Clerk’s office within 24 hours.
Continue

OWNER INFORMATION

Owner's Name*
Phone Number*
Home / Mailing Address*
Email Address
Have you ever been charged with or received a disposition of guilt either through supervision, probation, or conviction for any offense involving theft, burglary, fraud, bribery, assault, or moral turpitude under the laws of the State of Illinois, of any other state, or of the United States within five years of the date of application?*
1. Yes
2. No
If yes, list each individual offense and/or violation, the date and prosecuting jurisdiction
CERTIFICATION
I, the undersigned, do hereby certify that to the best of my knowledge and belief the above information is true, correct, and complete. I understand that failure to correctly and completely answer the above questions will be cause for denial of this license.
Electronic Signature Agreement*
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature*
Continue |Go Back

SELLER #1

Seller's Name
Phone Number
Home Address
Have you ever been charged with or received a disposition of guilt either through supervision, probation, or conviction for any offense involving theft, burglary, fraud, bribery, assault, or moral turpitude under the laws of the State of Illinois, of any other state, or of the United States within five years of the date of application?
1. Yes
2. No
If yes, list each individual offense and/or violation, the date and prosecuting jurisdiction
CERTIFICATION
I, the undersigned, do hereby certify that to the best of my knowledge and belief the above information is true, correct, and complete. I understand that failure to correctly and completely answer the above questions will be cause for denial of this license.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature
Date
Continue |Go Back

SELLER #2

Owner's Name
Phone Number
Home / Mailing Address
Have you ever been charged with or received a disposition of guilt either through supervision, probation, or conviction for any offense involving theft, burglary, fraud, bribery, assault, or moral turpitude under the laws of the State of Illinois, of any other state, or of the United States within five years of the date of application?
1. Yes
2. No
If yes, list each individual offense and/or violation, the date and prosecuting jurisdiction
CERTIFICATION
I, the undersigned, do hereby certify that to the best of my knowledge and belief the above information is true, correct, and complete. I understand that failure to correctly and completely answer the above questions will be cause for denial of this license.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature
Date
Continue |Go Back

SELLER #3

Seller's Name
Phone Number
Home Address
Have you ever been charged with or received a disposition of guilt either through supervision, probation, or conviction for any offense involving theft, burglary, fraud, bribery, assault, or moral turpitude under the laws of the State of Illinois, of any other state, or of the United States within five years of the date of application?
1. Yes
2. No
If yes, list each individual offense and/or violation, the date and prosecuting jurisdiction
CERTIFICATION
I, the undersigned, do hereby certify that to the best of my knowledge and belief the above information is true, correct, and complete. I understand that failure to correctly and completely answer the above questions will be cause for denial of this license.
Electronic Signature Agreement
By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
1. I agree.
Electronic Signature
Date