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– Step 1 of 2

Vendor name *

First

Last

Vendor email *

Email

Confirm Email

Vendor phone number *

Business / vendor name (if different) *

Vendor address *

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

What products will you sell at the market? *

Vendor type *— Select Choice —Food / beveragePrepared foodsCrafts / handmade goodsFarm / produceOther

/ email market

Do you need electricity?

• Yes
• No

If yes, describe your electricity needs *

Anything else you'd like us to know for your market vendor application? *

Resale certificate

Drag & Drop Files, Choose Files to Upload

Sales and Use Tax number *

Driver License *

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Valid driver’s license or state id.

Completed vendor PDF form (upload) *

Drag & Drop Files, Choose Files to Upload

CDTFA-410-D form.

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Please fill out the form and submit the California Department Of Tax And Fee Administration form CDTFA-410-D With your vendor registration form.

Don’t forget to include a copy of your resale certificate, or just add resale number on the form.