Commissary Agreement (New York City, New York)

This is the official Commissary Agreement from New York City Department of Health and Mental Hygiene. You can fill it in its original layout in your browser or with an AI assistant, then download it to review, sign and submit to the agency.

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Form details

Issuer: New York City Department of Health and Mental Hygiene
Jurisdiction: New York City, New York
Type: Food truck and mobile vending permits
Questions: 48
Last mapping review: 2026-10-02

Official blank PDF from New York City Department of Health and Mental Hygiene ↗

What this form asks

MFVU: Record Number
MFVU: Decal Number (prints in both places on the form)
MFVU: Type of Unit (choose one)
MFVU: Permit Holder
MFVU: DBA
MFVU: Telephone
MFVU: Email
MFVU: Mailing Address (Building Number, Street Name, State, Zip Code)
Commissary: Record Number (prints in both places on the form)
Commissary: Permit Holder
Commissary: DBA
Commissary: Mailing Address (Building Number, Street Name, State, Zip Code)
Approved Use Days: Sunday (checkbox)
Approved Use Days: Sunday Hours
Approved Use Days: Wednesday (checkbox)
Approved Use Days: Wednesday Hours
Approved Use Days: Thursday (checkbox)
Approved Use Days: Thursday Hours
Approved Use Days: Friday (checkbox)
Approved Use Days: Friday Hours
Approved Use Days: Saturday (checkbox)
Approved Use Days: Saturday Hours
Commissary Permit Holder's Name
Commissary Permit Holder: Date Signed (date)
Services Provided: Chemical Storage (checkbox)
Services Provided: Equipment storage (checkbox)
Services Provided: Facilities for cleaning and storage of vending machines (checkbox)
Services Provided: Facilities for food preparation (checkbox)
Services Provided: Propane/Fuel storage or supply (checkbox)
Services Provided: Refrigerated storage (checkbox)
Services Provided: Service and cleaning (checkbox)
Services Provided: Wastewater disposal (checkbox)
Services Provided: Water supply (checkbox)
MFVU Permit Holder's Name
Services Provided: Garbage disposal (checkbox)
Services Provided: Food Storage (checkbox)
Services Provided: Storage of vending unit when not in operation (checkbox)
Services Provided: Supplies (food and/or supplies provided by Commissary) (checkbox)
Services Provided: Ware washing facilities (checkbox)
Services Provided: Other (checkbox)
Services Provided: Other (describe) (multiline)
Commissary: Telephone
Commissary: Email
Approved Use Days: Monday (checkbox)
Approved Use Days: Monday Hours
Approved Use Days: Tuesday (checkbox)
Approved Use Days: Tuesday Hours
MFVU Permit Holder: Date Signed (date)

Review, sign and submit

PaperPorter fills the form but does not submit it or approve anything. Signatures, initials and staff-only areas are left for the right person. Confirm current fees, attachments and filing instructions with New York City Department of Health and Mental Hygiene.

Other New York City forms

Application to Service Mobile Food Vending Unit at Alternative Facility New York City Department of Health and Mental Hygiene
Standard Application for New License or Permit (Mobile Food Vendor License application forms) New York City Department of Health and Mental Hygiene

Food truck and mobile vending permits in other places

Frequently asked questions

Does PaperPorter submit this form?

No. You download the completed PDF, then review, sign and submit it to New York City Department of Health and Mental Hygiene yourself.

Can I fill it without an AI assistant?

Yes. Fill it in your browser and download the completed PDF. An assistant such as ChatGPT or Claude can also ask you the questions and fill it for you.