Illinois State Seal
Illinois Gaming Board  
Video Gaming Location License Application  


3. BUSINESS/INDIVIDUAL INTERESTS



APPLICANT SHALL DISCLOSE ALL BUSINESS ENTITIES, INDIVIDUALS, AND TRUST ENTITIES TO SHOW 100% OWNERSHIP OF THE APPLICANT.

Using the buttons below, Applicant shall add disclosure information for all of the following:
  • Each Individual, Business Entity and Trust that is an owner of the Applicant to show 100% direct equity ownership of the Applicant. In addition, Applicant shall add disclosure information for each Individual, Business Entity and Trust with a greater than 1% Indirect Interest of a pecuniary nature in the Applicant (i.e., ownership in the Applicant through holdings in other Business Entities). For each owner that is a Trust, disclose the Grantor, all Trustees and all Beneficiaries. Publicly-held corporations disclose shareholders with a 5% or more ownership interest.
  • The Video Gaming Manager (the one employee or owner of a licensed Video Gaming Location who will primarily Manage, oversee or be responsible for the Video Gaming Operation therein and the coordination of such with a Terminal Operator and the central communications system).
  • Each Officer and each Director/Board Member for the Applicant.





* To add a Grantor, Trustee or Beneficiary, first create the Trust, next select the Trust, finally add the individual near the bottom of the page.