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Step One

Mobile Food Unit Type (Select One)
1. Unrestricted
2. Restricted
3. Limited
Type of Foods / Goods to Be Offered
Mobile Food Unit Name
Special Event Name & Location
Operating Dates and Hours (must be concurrent with Special Event)
TX Sales & Use Tax Permit Number
Upload Certificate Copy
Mobile Food Unit Owner Name
Mobile Food Unit Owner Phone Number
Mobile Food Unit Owner Mailing Address
Mobile Food Unit Owner Email Address
Mobile Food Unit Owner Date of Birth
Event Organizer Contact Name
Event Organizer Contact Number / Email
Business Type
1. Proprietorship
2. Partnership
3. Corporation / LLC
Number of Employees Working Event
Mobile Food Unit Make / Model / Year
Mobile Food Unit Color
Plate Number & State
Mobile Food Unit VIN Number
Application Must Include
- Applicant's Driver's License
- Copy of Texas Sales and Use Tax Permit
- $25 Permit Application Fee
- Current Grayson County Health Department temporary mobile food establishment permit
- If selling from the vehicle, proof of liability insurance
- Please allow 3 to 5 business days for processing
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.
Applicant Signature
Date
Date
Continue

Step Two

Authority to Release Information
I hereby authorize you to release any information in your files about my current or previous law enforcement and or criminal justice records. I hereby release you, as the custodian of such records, and any law enforcement agency or criminal justice agency, including its officers, employees, or related personnel, both individually and collectively, from any liability for damages of whatever kind, which may at any time result to me, my heirs, family or associates because of compliance with this authorization and request to release information, or any attempt to comply with it. I am also furnishing my date of birth voluntarily to facilitate the location of records in connection with this release. Should there be any question as to the validity of this release, you may contact me as indicated as given.
Release to the City Clerk of the City of Denison, Texas
Applicant Name
Applicant Date of Birth
Phone Number
Email Address
Street Address
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.
Applicant Signature
Notary Public to Complete
Subscribed & Sworn Before Me on
Date
Date
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.
Signature, Notary Public
Seal Notary Public

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

This field is not part of the form submission.
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Special Event Mobile Vendor Permit Application

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