Vendor License Application

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Peddler/Vendor License

Date

Name

First

Last

Name of Business/Company

Types of goods or services vended

Address of Business/Company

City

State/Province

Zip/Postal

Home Phone

Cell Phone

Address

City

State/Province

Zip/Postal

Date of Birth

Gender

Date Issued

Date Expired

Signature

Driver's License Upload

Maximum file size: 516MB

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