Standard Application for New License or Permit (Mobile Food Vendor License application forms) (New York City, New York)

This is the official Standard Application for New License or Permit (Mobile Food Vendor License application forms) 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.

Fill this form Use your assistant

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: 123
Last mapping review: 2026-10-02

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

What this form asks

Standard Application: Application Date: Month
Standard Application: Application Date: Day
Standard Application: Application Date: Year
Standard Application: Name of License/Permit
Section A: Name of Corporation, Partnership, Partners or Individual Owner (Last Name First)
Section A: Telephone Number (with area code)
Section A: Trade Name/Doing Business As (DBA)
Section A: Fax Number (with area code)
Section A: Building Number
Section A: Street
Section A: Premises Location (Floor, Store #, Booth #)
Section A: E-mail Address
Section A: City or Town
Section A: State
Section A: Zip Code
Section A: Gender (optional) (choose one)
Section A: What language do you speak? (optional)
Section A: Date of Birth (if applying as an individual): Month
Section A: Date of Birth (if applying as an individual): Day
Section A: Date of Birth (if applying as an individual): Year
Section A: I agree to receive all official notices from the Department of Health only by email at the email address provided (checkbox)
Section A: I would like to receive Department of Health publications only by email at the email address provided (checkbox)
Section B: Date Expected to Open/Start Operating: Month
Section B: Date Expected to Open/Start Operating: Day
Section B: Date Expected to Open/Start Operating: Year
Section C: NYS Sales Tax ID #
Section C: Social Security Number (if applying as an individual)
Section C: ITIN Number (if no SSN and applying as an individual)
Section D: Mailing Address (if different): Street Address (include apartment #, PO Box #)
Section D: Mailing Address (if different): City or Town
Section D: Mailing Address (if different): State
Section D: Mailing Address (if different): Zip Code
Section E: Owner/Partner/Officer 1: Name (Last, First)
Section E: Owner/Partner/Officer 1: Phone Number
Section E: Owner/Partner/Officer 1: E-mail Address
Section E: Owner/Partner/Officer 1: Title
Section E: Owner/Partner/Officer 1: Street Address
Section E: Owner/Partner/Officer 1: City
Section E: Owner/Partner/Officer 1: State
Section E: Owner/Partner/Officer 1: Zip Code
Section E: Owner/Partner/Officer 2: Name (Last, First)
Section E: Owner/Partner/Officer 2: Phone Number
Section E: Owner/Partner/Officer 2: E-mail Address
Section E: Owner/Partner/Officer 2: Title
Section E: Owner/Partner/Officer 2: Street Address
Section E: Owner/Partner/Officer 2: City
Section E: Owner/Partner/Officer 2: State
Section E: Owner/Partner/Officer 2: Zip Code
Section E: Owner/Partner/Officer 3: Name (Last, First)
Section E: Owner/Partner/Officer 3: Phone Number
Section E: Owner/Partner/Officer 3: E-mail Address
Section E: Owner/Partner/Officer 3: Title
Section E: Owner/Partner/Officer 3: Street Address
Section E: Owner/Partner/Officer 3: City
Section E: Owner/Partner/Officer 3: State
Section E: Owner/Partner/Officer 3: Zip Code
Section E: Owner/Partner/Officer 4: Name (Last, First)
Section E: Owner/Partner/Officer 4: Phone Number
Section E: Owner/Partner/Officer 4: E-mail Address
Section E: Owner/Partner/Officer 4: Title
Section E: Owner/Partner/Officer 4: Street Address
Section E: Owner/Partner/Officer 4: City
Section E: Owner/Partner/Officer 4: State
Section E: Owner/Partner/Officer 4: Zip Code
Section F: Insurance Coverage (choose one)
Section F: Workers' Compensation Insurance Carrier
Section F: Workers' Compensation Insurance Policy #
Section F: Workers' Compensation Insurance Expiration Date (date)
Section F: Disability Benefits Insurance Carrier
Section F: Disability Benefits Insurance Policy #
Section F: Disability Benefits Insurance Expiration Date (date)
Section F: Form CE-200 Issuance Date (date)
Section F: Form CE-200 Exemption Certificate Number
Person Signing the Application: Title
Are you 18 years of age or over? (choose one)
Person Signing the Application: Telephone Number
If you are not registered to vote where you live now, would you like to register to vote here today? (choose one)
Affidavit of Home Address: Name of the Person With Whom the Applicant Lives
Affidavit of Home Address: Residing At (Street Address, Borough, State and Zip Code)
Affidavit of Home Address: Name of the Person Applying for Permit/License
Affidavit of Home Address: Relationship to Applicant
Affidavit of Home Address: Print Name of Person With Whom the Applicant Lives
Affidavit of Home Address: Print Name of Applicant
Authority to Act: Applicant Name
Authority to Act: 1. Relationship to Business
Authority to Act: 1. Name of Business (as it appears on the Certificate of Partnership and/or Business)
Authority to Act: 1. Business Street Address, Borough, State and Zip Code
Authority to Act: 1. Business Phone Number (area code and number)
Authority to Act: 1. Business Email Address
Authority to Act: 2. Full Name of Designated Representative
Authority to Act: 2. Full Name of Representative's Business
Authority to Act: 2. Representative Office/Residence Street Address, Borough, State and Zip Code
Authority to Act: 2. Representative Telephone Number (area code and number)
Authority to Act: 2. Representative Email Address
Authority to Act: License/Permit/Certificate Category
Authority to Act: Print Name
Authority to Act: Date Signed (date)
Mobile Food Vendor License: Application Date: Month
Mobile Food Vendor License: Application Date: Day
Mobile Food Vendor License: Application Date: Year
Mobile Food Vendor License: Licensee Name: Last
Mobile Food Vendor License: Licensee Name: First
Mobile Food Vendor License: Licensee Name: Middle
Mobile Food Vendor License: Height: Inches (number)
Mobile Food Vendor License: Date of Birth: Month (MM)
Mobile Food Vendor License: Date of Birth: Day (DD)
Mobile Food Vendor License: Date of Birth: Year (YYYY)
Mobile Food Vendor License: Height: Feet (number)
Mobile Food Vendor License: Weight (lbs.) (number)
Mobile Food Vendor License: Eye Color
Mobile Food Vendor License: Gender (choose one)
Mobile Food Vendor License: List All of the Names You May Be Known By
Mobile Food Vendor License: Languages Spoken
Mobile Food Vendor License: Do you want all official notices sent to you only by email? (choose one)
Mobile Food Vendor License: Do you want to receive publications from the Health Department by email? (choose one)
Mobile Food Vendor License: Names of Permittees' Mobile Food Vending Units You Will Be Operating: 1
Mobile Food Vendor License: Names of Permittees' Mobile Food Vending Units You Will Be Operating: 2
Mobile Food Vendor License: Names of Permittees' Mobile Food Vending Units You Will Be Operating: 3
Mobile Food Vendor License: Names of Permittees' Mobile Food Vending Units You Will Be Operating: 4
Mobile Food Vendor License: Names of Permittees' Mobile Food Vending Units You Will Be Operating: 5

…and 3 more.

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

Commissary Agreement New York City Department of Health and Mental Hygiene
Application to Service Mobile Food Vending Unit at Alternative Facility 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.