Action Center / Transient Merchant Application / Davenport, Iowa

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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 1*

City*

State*

ZIP*

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

Province / Region*

Postal Code*

Home Office Phone*

Phone Area Code-Phone 3-Phone 4 ext Extension

Sales Manager's Name*

Sales Manager Permanent Address*

Sales Manager's Phone*

Phone Area Code-Phone 3-Phone 4 ext Extension

Location where you are staying in Davenport during the sale*

Description of Goods to be Sold*

Is this a "Cash & Carry" Sale*

Yes No

Please Do Not Complete The Following Field

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.*