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2. TRANSIENT MERCHANT LICENSE/OPEN SALES LOT APPLICATION
   Community Development Department - Building Division - 5127 Oakton Street - Skokie, IL 60077 - Phone: (847) 933-8223
3. 
7. Applicant Information
9. Name:*
10. Date:*
12. Street Address:
13. City/State/Zip:
15. Illinois Retailer Occupational Tax #:
17. If Other Than Individually Owned
19. Partnership:
20. Name & Title:
21. Corporation:
23. Address:
24. Phone #:
26. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
28. Applicant Signature*
30. General Information
32. Location where article are to be bought or sold:
33. Types of articles:
35. Articles on consignment from
37. Name:
38. Address:
39. Phone #:
41. Fees:
43. Transient Merchant Fee: $25.00 plus $25.00 per day
44. Open Sales Lot: $150.00
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit Submit and Print

* indicates a required field