Golf Cart or Off-Road Vehicle Permit Application

Golf Cart/ORV Application

GOLF CART AND OFF-ROAD VEHICLE PERMIT APPLICATION

Terry Martin, Administrator & Town Manager
345 Morton St., Shipshewana, IN 46565
Phone: (260) 768-4743 x701
townmanager@shipshewana.gov

1. Applicant must fill this form completely. Mark any inapplicable box “N/A.”
2. Application may include all permit fees, photo ID, proof of proper agency (if you don't own the vehicle), and (for facilities) an appropriate bond or insurance certificate, proof of ownership and VIN number. All ORVs may require proof of registration.
3. By signing Agreement, Applicant agrees operate said vehicle in accordance with Shipshewana Town Code and Indiana State Law.

PERMIT TYPE / FEE AMOUNT
Initial Annual Permit / $55.00
Renewal Annual Permit / $25.00
Weekend Pass / $50.00

Applicant Information

Enter the applicant information below.

Applicant's First Name

Applicant's Last Name

Applicant's Address

Address Line 1

City/Town

State

Zip Code

Applicant's Email

Applicant's Phone/Mobile

Vehicle Information

Enter your vehicle's information below.

What Type of Permit

New

Renewal

Weekend

Vehicle Year

Vehicle Make

Vehicle VIN

Vehicle Body Color

Insurance Company

Policy No.

Insurance Phone

Expiration Date

No person shall Operate or allow the Operation of a Golf Cart or Off-Road Vehicle on a Town Street without proof of liability insurance or acceptable substitute in an amount not less than the minimum the State of Indiana requires for automobiles.

Upload proof of insurance.

Choose File

Vehicle Operator Information

Enter information for all vehicle operators.

No person shall Operate a Golf Cart or Off-Road Vehicle on a Town Street unless that person holds a driver’s license or is at least 18 years of age and holds either an identification card issued under IC 9-24-16 or a photo exempt identification card issued under IC 9-24-16.5.

Enter each operator's full name and driver's license or state issued ID number. Please enter one entry per line.

Safety Inspection

The golf cart or off-road vehicle must receive a safety inspection prior to use on Town streets. Even for weekend pass permits. The applicant must contact the Shipshewana Police Department to schedule an inspection after the application and fee are paid. They will be required to show proof of payment before the inspection.

Once you submit this application, you will receive information via email to schedule a safety inspection.

I agree to operate said vehicle in accordance with Shipshewana Town Code and Indiana State Law.

Applicant, on behalf of self and the golf cart or off-road vehicle owner, hereby irrevocably releases, discharges, and agrees to indemnify, defend, and hold harmless the Town, its officers, employees, representatives, agents, boards, departments, related municipal corporations, assigns, and/or any person, firm, or corporation identified in interest therewith, whether individually or jointly (collectively, the “Town Group”), from and against any and all claims, liabilities, fees, fines, penalties, damages, punitive damages, liens, costs, expenses, lost wages or benefits, and attorneys’ fees (including paralegal fees), and any amounts paid in good faith arising from any threatened or pending claim, demand, action, suit, settlement, or judgment, whether any such amount is known or unknown, and whether past, present, or future, arising out of or resulting from the permitted use of a golf cart and/or off-road vehicle and/or the application process therefor; provided however, that this indemnification does not apply to the extent of any act or omission of a respective Town Group member amounting to willful misconduct or gross negligence.

Applicant's Signature

Sign Here