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2. 
3. Solicitor/Vendor/Peddler Permit Application

5. Every individual / organization wishing to go to private property to sell or advertise as defined by the Town Code shall complete this application. The fee for an organization that applies for the solicitor's permit and the first individual applicant is $275.00 and $95.00 for each subsequent individual. Fees are payable in cash, check or credit card (Visa/MC/Discover). 

7. Entering private property for the purpose of peddling or soliciting is prohibited before 9 am of any day or after 8 pm of any day except upon the invitation of the householder or occupant.
9. Ringing the bell, knocking on the door or entering the building with a "No Soliciting" sign is prohibited.
11. WARNING:
    This application is required to be sworn under oath. Any false swearing is punishable as provided in the Penal Law of the State of New York.
15. IMPORTANT:
    After completing the application, click the "Print Only" button at the bottom of the page. Handwritten applications will not be accepted.
17. • Social Security Number of applicant must be manually added to application after it is printed.
    • Completed applications must be notarized prior to submission.
    • Passport style photographs of applicants must be supplied via email prior to submission.
    • Payment is due when submitting application.
21. First Name*
23. Middle Name*
25. Last Name:*
27. Address1:*
29. Address2:
31. City:*
32. State:*
34. Zip:*
35. County*
37. Phone Number:*
38. Social Security Number

    [ **REQUIRED**]

    HAND WRITE SOCIAL SECURITY NUMBER PRIOR SUBMITTING APPLICATION

    ________________________________________________

39. Date of Birth:*
    Date of Birth:
41. Company Name*
43. Veteran or Other Fraternal Organization?*

    1. YES
    2. NO
44. If Yes, list Name and Address of applicant's local chapter
46. Is applicant Not-For-Profit (501)(c)(3)*

    1. YES (Attach Documentation)
    2. NO
47. Is Applicant a religious organization?*

    1. YES
    2. NO
49. Prior Violations:*

    _{List any past violations of the TOWN OF BRIGHTON Peddlers, Solicitors and Vendors Law or any comparable laws, ordinances, statutes, rules or regulations OF ANY OTHER MUNICIPALITY or of the State Of New York Door to Door Sales Protection Act by the COMPANY, APPLICANT or by any officer, director, partner or employee or agent of the company, WITHIN THE PAST TEN (10) YEARS.}

51. Prior Convictions:*

    _{List all FELONIES AND/OR MISDEMEANORS with which you have been convicted within the last ten (10) years, including a description of the charges, date charged, and the name and address of the Court in which such charge was brought as well as the disposition of each such charge}

53. Description of Goods or Services to be offered:*

    _{Provide a detailed description of the type, name and brand of ALL goods, wares, commodities or services to be offered for sale, together with showing the amount, quality, and value of all items to be marketed. **NOTE** Your permit is only good for such items as you fully describe on this application form.}

55. Description of Proposed Plan of Operation:*

    _{Provide a detailed description of your specific proposed plan of operations to be used in merchandising the products or services. If door-to-door solicitation is proposed, set forth the DAYS and HOURS of EACH WEEK that such solicitation might occur.}

57. You MAY NOT DEVIATE from the above stated proposed plan of operations without submission AND APPROVAL of a new application.
59. If a form of contract or order form to be signed by customers is to be used, a copy of such form, complying with the provisions of New York Personal Property Law Article 10-A, if applicable, must be attached to this application.
61. **NOTE** If the application has more than one (1) employee agent or other authorized representatives, who will work in the Town of Brighton, the same information must be supplied as to each such person, who must complete and swear to a separate application form and pay an individual permit certificate fee.
63. Name of Supervisor:*
    Name of authorized agent who is responsible for the supervision of employees while working in the Town of Brighton
64. Phone Number of Supervisor:*
    Phone number of authorized agent who is responsible for the supervision of employees while working in the Town of Brighton
66. YOU MAY NOT:
68. (1) Enter upon private property for the purpose of peddling or soliciting before the hour of 9:00 AM or after 9:00 PM, except upon the prior invitation of the householder or occupant.
70. (2) Sell or vend within 250 feet of any school property between the hours of 9:00am and 4:00pm on school days.
    (3) Violate any other restrictions listed in Town of Brighton Town Code Section 121-9.
72. NO ENDORSEMENT
    The granting of a permit or certificate by the Town of Brighton does not constitute an endorsement or official approval of your products or services. It is unlawful to make any representation to the contrary.
74. 
77. 
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78. Print Only

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