PEDDLER'S LICENSE ON-LINE APPLICATION

COPY OF PHOTO ID REQUIRED. The City of Grove is unable to take on-line payments at this time, you may make payment over the telephone at 918-786-6107. You may also stop by the City Offices or mail payment along with supporting documentation to Grove City Hall, 104 W. 3rd St., Grove, OK 74344. NO LICENSE WILL BE GRANTED UNTIL ALL DOCUMENTATION IS PROVIDED.

This application must also be processed through Grove Police Department. Your complete License Registration information must be included as well as your Driver's License number to confirm there are no felony convictions or outstanding warrants. The signing of this application allows permission for Grove Police Department to verify your answers.

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FORM TITLE

APPLICATION FEE (NON-REFUNDABLE) $

LICENSE FEE (UPON APPROVAL OF APPLICATION) $

APPLICANTS FULL NAME *

Please include First, Middle and Last Name

APPLICANTS PREVIOUS NAME(S)

Please include any previous name(s) used or alias name(s)

APPLICANTS ADDRESS *

This should include Building or Apartment number (if applicable)

APPLICANTS CITY, STATE, ZIP *

APPLICANTS LEGAL ADDRESS (IF DIFFERENT FROM ABOVE)

APPLICANTS PHONE NUMBER *

Including Area Code

APPLICANTS DATE OF BIRTH

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BUSINESS LOCATION *

Include ALL information that pertains to the location you will be peddling, including but not limited to: Address, Description of Location, Business Name, etc.

TIME PERIOD APPLICANT WILL CONDUCT BUSINESS *

Include ALL dates or time periods you will be conducting business at the location listed above

DESCRIPTION OF BUSINESS *

Brief description of the business to be conducted and the ITEMS TO BE SOLD.

DRIVERS LICENSE NUMBER (INCLUDE STATE) *

This information will be verified by Grove Police Department

VEHICLE LICENSE PLATE (INCLUDE STATE) *

License Plate Number and State where tag was purchased. This information will be verified by Grove Police Department.

OKLAHOMA TAX COMMISSION NUMBER *

Verification of applicant or the applicant employer is a vendor registered with the Oklahoma Tax Commission or other proof that sales tax has been or is being paid on the items sold or proof that applicant's employer is exempt from the payment of sales tax. If exempt from sales tax, please type "EXEMPT"

CONTENT OF SIGNS

Include all content of signs to be used

APPLICANTS EMPLOYER *

Please include Name and Address of the applicant's employer, together with a brief description of credentials showing the exact relationships. If you are self-employed please type "SELF EMPLOYED"

HAS APPLICANT EVER BEEN CONVICTED OF A FELONY *

Yes

IF YES, APPLICANT STATEMENT (MUST BE INCLUDED)

If convicted of a felony, the nature of offense and the punishment and penalty assessed therefor

SIGNATURE OF APPLICANT *

Include First and Last Name

DATE OF APPLICANTS SIGNATURE

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AGREEMENT BOX *

I hereby certify the information provided is true and correct to the best of my knowledge. I understand that checking this box constitutes a legal signature confirming that I acknowledge and authorize investigation of all statements contained in this application. I understand that misrepresentation or omission of facts called for is cause for denial of application.

PEDDLER'S LICENSE ON-LINE APPLICATION

Contact Information