From: 

PERMANENT ADDRESS 
MAILING ADDRESS 

VEHICLE: MAKE 

WHAT WILL YOU BE SELLING? 
SALES TAX LICENSE NO. 

If Yes, please describe 
What penalty were you assessed? 

For Staff: Date Paid 	Amount $ 

TOWN OF IGNACIO
VENDOR PERMIT APPLICATION

DATE

Dates valid (not to exceed 1 year)

to

NAMEOF

APPLICANT

PHONE(S)

YEAR

STATE

LICENSE #

NAME OF EMPLOYER

ADDRESS OF EMPLOYER

PHONE NUMBER OF EMPLOYER

F001) ESTABLISHMENTS must attach a current Colorado Retail Food Service License.

i hereby acknowledge that when selling merchandise within the Town of Ignacio I am required
to collect 6. 9% sales tax and remit it to the Colorado Department of Revenue. I further
acknowledge that a sales tax license number is required.

Have you, the applicant, been convicted of any crime, misdemeanor or violation of municipal

ordinance within the past five years? Yes

No

PermitFees. $5. 00/ Day, $20/ Week, $40/ Month, $75/Annual (DOES NOT APPLY TO
RALLY WEEKEND)

Staff signature

Checks payable to: TOWN OF IGNACIO

I HEREBY SWEAR THAT THE ABOVE STATEMENTS ARE TRUE AND CORRECT.

SIGNATURE OF PERMIT APPLICANT

0-/ shortcut to Municipal Code/ Muni Code Appendix 2006-7

 

ATTACH COPY OF PICTURE IDENTIFICATION

0-/ shortcut to Municipal Code/ Muni Code Appendix 2006-7