Required fields are marked with asterisks (*)

Mobile Food Vendor License Application

All applications, licenses and permits are subject to approval.

Type of vendor

Food Vendor

Ice Cream Truck

Owner's name

Owner's Phone Number

Owner's Address

Owner's Email Address

Vehicle Operator

Operator's Address

Operator's Phone Number

Operator's Email

A copy of a Photo ID or Driver's License is required. Please upload a copy.

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Vehicle License and Registration with VIN Numbers

Please upload a copy of the vehicle license and registration.

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State or County Health Department License or Permit Number

A copy of the State or County Health Department License or Permit is required. Please upload a copy.

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Illinois Department of Revenue Certificate of Registration Number

What are the dates of sale and where do you intend to do business?

A copy of Illinois Department of Revenue Certificate of Registration is required. Please upload a copy.

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A copy of motor vehicle and liability insurance is required. Please upload a copy.

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Please upload copies of any additional state issued license held by the applicant that are related to these goods or services

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Please upload a copy of a written lease or other proof from the owner of the location where you intend to sell.

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I certify that the information provided is true, accurate, and complete. I understand that the completion of this application does not guarantee approval

Yes

For Office Use Only Filed this day of , 20 .
City Clerk
Date of issue: License: Fee:$ Effective Dates: