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Jefferson Township
Jefferson Township, N.J. • 1033 Weldon Rd, Lake Hopatcong NJ.
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TOWNSHIP OF JEFFERSON

1033 WELDON ROAD

LAKE HOPATCONG, NJ   07849

(973) 208-6132

 

PERMIT NO.  __________                                                     FEE:  $125.00

                                                                                                                                                                                        

APPLICATION FOR SOLICITOR’S PERMIT

 

License Period:  January 1 through December 31, YEAR: __________

 

All applicants are subject to the requirements of the Township of Jefferson's Ordinance for Peddling, Hawking, Soliciting, Chapter 69 and Chapter 55-13 (attached)

 

NAME OF APPLICANT         _____________________________________________________

 

ADDRESS OF APPLICANT  _____________________________________________________

              _____________________________________________________

(If a firm or corporation, the names and addresses of all the Officers and registered agents

or partners (please use reverse or attach this information to application).

 

PHONE NUMBER(S)             ____________________________________________________

                                     Check box if above phone number is unlisted

DESCRIPTION OF APPLICANT: (Check Category)

(   )  Charitable                                            

(   )  Religious

(   )  Public Utility Employee

(   )  Delivery or Merchandise

(   )  Selling Home-grown vegetables

(   )  Exempt Fireman of Volunteer Fire Co.

(   )  Veteran having Peddler’s License under N.J.S.A. 45:24-9 & 10

(   )  School, political or civic organization, Benevolent Society, Service Club or Organization Not

        For Profit located in Jefferson Township or elsewhere

 

Date of Birth            _____________________

Place of Birth           _____________________

Color of Eyes           _____________________

Color of Hair            _____________________

Drivers License No.   _____________________

 

State briefly nature of business and description of merchandise or service to be sold:

 

____________________________________________________________________________

 

How will business be conducted? (Example:  door-to-door)

 

 

Name & Address of Employer, if any, with credentials showing the exact relationship:

 

 

 

 

 

 

______________________Phone_________________________________________________

 

Length of time for which license is desired:  _________________________________________

                                                               (EXPIRES DECEMBER 31)

 

If vehicle is to be used, description of same and License Plate State and Number:

 

____________________________________________________________________________  

Year            Make/Model                      Color                     License Plate State/Number

 

Location where merchandise is to be sold, manufactured or produced, where goods are located and method of delivery: _________________________________________________________

 

Two Business References located in Morris County, New Jersey, or in lieu thereof, such other available evidence of character:

Name________________________________________Phone__________________________Address_____________________________________________________________________

Names_______________________________________Phone__________________________

Address_____________________________________________________________________

 

Was applicant ever convicted of any crime, misdemeanor, or violations of

Municipal Ordinances:  _________

If Yes, state nature of offense, data, etc.

 

 

Attach 2 Photographs of applicant, 2”x2”, taken within 60 days prior to date application, showing head and shoulders.

 

 

(Owner /Representative Signs Here)______________________________________________

 

Date  ____________________

APPROVALS

POLICE DEPT.

 

 


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