Action Center / Transient Merchant Application / Davenport, Iowa

Transient Merchant Application

Step 1 of 1

Complete the application to apply for a Transient Merchant License with the City of Davenport

* Denotes a required field

Name of Company or Business Conducting Sale

Local Address of Sale

Date(s) of Sale

Country

Address

City

State

ZIP

Zip-Zip +4
Second portion of ZIP Code is optional.

Province / Region

Postal Code

Home Office Phone

Home Office Phone Area Code-Home Office Phone Prefix-Home Office Phone Line Number ext Home Office Phone Extension

Email Address

Company Website URL

ProtocolURI

Sales Manager's Name

Sales Manager Permanent Address

Sales Manager's Phone

Sales Manager's Phone Area Code-Sales Manager's Phone Prefix-Sales Manager's Phone Line Number ext Sales Manager's Phone Extension

Location where you are staying in Davenport during the sale

Description of Goods to be Sold

Please Do Not Complete The Following Field

Is this a "Cash & Carry" Sale

Yes No

If orders are taken for future delivery, is a down payment requested

Yes No

Locations of other sales conducted in the Iowa & Illinois area within the last 3 years

Has this company or any of its sales people ever been denied or had a license revoked in another city?

Yes No

If yes, please explain

List names and home addresses of all sales people who will be working in Davenport.

Have any of these sales people been convicted of a felony within the last 5 years?

Yes No

If yes; list name, State of conviction, charge, and sentence

Iowa Sales Tax I.D. No.

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