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Updated 01/2025 CITY OF MOSCOW SOLICITOR / PEDDLER / CANVASSER LICENSE – RENEWAL APPLICATION PROOF OF REGISTRATION FORM APPLICATION FEE: ☐ Fingerprints done within 5 years ($36.00) ☐ Fingerprints needed ($62.00) Name LAST FIRST MIDDLE (MAIDEN) Local Address: STREET CITY STATE ZIP Cell or Local Phone Email: Business Name or Employer Name: Business Address STREET CITY STATE ZIP Business Phone Fax Number: Tax ID#: Briefly describe the nature of your business and goods to be sold or services to be performed: Have you been issued a peddler’s or solicitor’s license by any city in Idaho in the last five years? [ ] YES [ ] NO If “YES” above, what city: Any change to place of manufacture/production of goods, location of goods and/or proposed delivery: [ ] YES [ ] NO If you answered “YES” above, please explain: Have you ever, anywhere or at any time, been found guilty of, plead guilty to, received a withheld judgement, or admitted to the elements of any crime listed in Moscow City Code Section 9-3-8 or acknowledged there is sufficient evidence where a judge or jury could find you committed any of the offenses listed in MCC 9-11-9 beyond a reasonable doubt? [ ] YES [ ] NO If you answered “YES” above, please state the following for each offense: DATE OF OFFENSE NATURE OF OFFENSE PENALTY ASSESSED THE CITY OF MOSCOW REQUIRES: 1. A processing fee with this Application (see fees above). Fee is nonrefundable. 2. A valid Driver’s License or other DMV approved identification to be shown and copied. 3. Photograph taken within the last sixty days of the date of this application (approximately two inches by two inches that shows the head and shoulders in a clear and distinguishing manner). I, the undersigned applicant, swear that if a vendor license is granted to me, it will not be used or represented as an endorsement by the City of Moscow for vending operations thereunder. I also acknowledge, certify and declare that I have read all of the above, and declare under penalty of perjury pursuant to the law of the State of Idaho that each and every statement made is true, correct and complete. REQUIREMENT: SIGN IN FRONT OF A MOSCOW POLICE DEPARTMENT DEPUTY CLERK Applicant’s Signature Date ATTEST: Clerk/Deputy Signature Date