TOWN OF BARKSDALE
TRANSIENT MERCHANT PERMIT APPLICATION

Applicant’s Name:                 

Mailing Address:

Phone Number:

Email Address:

Complete list of goods or merchandise to be sold and/or services to be delivered and location: 

Description (year, make, type) and valid license plate number and state of registration of all vehicles to be used in Soliciting, Vending, and Peddling: 

Date or Dates when Soliciting, Vending and/or Peddling will occur: 

In addition to filling out this application the applicant must provide the Town of Barksdale with the following documentation: a valid photo ID either a driver’s license or a State issued photo ID, a copy of the vehicle’s current proof of Commercial liability insurance, a copy of business’s liability and workers compensation  insurance , a copy of the applicant’s current State of Wisconsin Sales and Use Tax Permit together with written documentation from the State that all sales tax that may be due and owed by the vendor has been paid in full, proof of a valid Federal Employer Identification Number(EIN).

Also, any required state, federal or local certification that is required for the type of business that is being done.

This application must be accompanied by a check or money order in the amount of $25 per day of anticipated use or $500.00, whichever is less, payable to The Town of Barksdale. The fee will be returned to the applicant if the application is denied. The fee will not be returned if the applicant has their permit revoked by the Town of Barksdale Board. There will be no refund of the fee after the permit is granted. Permits granted are valid for 12 months from the date they were approved by the Town of Barksdale Board. If you apply for a daily permit the dates of operation must be listed and only used on those dates.

 Mail completed application to: Town of Barksdale Town Hall,     29025 E. Ondossagon Rd.,    Ashland, WI 54806                                           
                                                             
Applicants Signature:                              

Date:

______________________________________________
Town of Barksdale board meeting date: 

Approved: Denied: 

Town Chair Signature:

Town Clerk Signature: