Wichita Business License Application

Applicant Information

Name (First Middle Last)*
Address*
City* State* Zip*
Primary Phone* Email*

Date of Birth*

Open the calendar popup.

Primary Contact Person to Whom the City Will Direct Inquiries

Name*
Address*
City* State* Zip*
Primary Phone* Email*

Business Information (location for which license is desired)

Business Name (Entity or Personal Name)*

DBA Name (If applicable) Required

Attention
Business Physical Address
(Please include unit/suite number. PO Box's will not be accepted for physical address) *
City* State* Zip* Business Phone*

Mailing Address (Official address where correspondence may be sent, and complaints served.)

Mailing Address same as Business Address

Mailing Address *

Mailing City* Mailing State* Mailing Zip*

Mobile Food Vendor Questions

List legal ownership*

select

KS Sales Tax Number*

KS Food Establishment Number*

Nature of business, and types of food and/or beverages to be offered for sale*

Is your mobile food unit equipped to sell hot food?* Yes No

Has your unit been inspected by a member of the Central Kansas Fire Marshal's MFV Coalition?* Yes No

Is your permit for a special event* Yes No

Has the applicant ever had a mobile vending license or other similar license, permit, or registration revoked or suspended under the Code of the City of Wichita or any similar laws of any other city or state? * Yes No

Please upload proof of general liability insurance covering the mobile vending operations

Please upload proof of liability insurance covering the vending vehicle and/or trailer

Please upload copy of valid driver's license for operation of the class of vehicle identified in the application for any owner or employee who will be operation the identified vehicle

Vehicle Information

Truck Information

Truck Owner Name*

Make*

Model*

VIN*

Does the business have a trailer? Yes No

Certification/Signature

The applicant understands and agrees that the license issued will not be used or represented in any way as an endorsement of the applicant by the City of Wichita or by any department, officer, or elected or appointed official of the City.

The applicant understands that, in accordance with Section 3.15.070 of the Municipal Code for the City of Wichita, all Mobile Food Vendor (MFV) units must be annually inspected by the City of Wichita or a member of the Central Kansas Fire Marshal’s MFV Coalition prior to license issuance.

No person whose duties include working upon the premises of the MFV unit is a registered sex offender, and the applicant has, subject to audit, performed the necessary background check of all such persons to ensure that the statement is correct.

When the MFV unit is not in use, it will be stored or parked in compliance with all ordinances and regulations of the City of Wichita, and that failure by the applicant to legally store the MFV unit may result in the suspension or revocation of the applicant’s license.

By submitting this application, I ,

, the applicant, or individual legally authorized to sign for the corporation or partnership, state that upon signing this application, I understand and agree to the statements above and to the provisions set forth in Chapter 3.15, the Code of the City of Wichita, Kansas, and certify that the information and answers herein contained are complete and true to the best of my knowledge.

Executed the .

Please sign your name below, using the mouse or your touch screen enabled device. To use mouse, left click and hold while dragging the mouse over the signature line.