Illinois State Seal
Illinois Gaming Board  
Video Gaming Location License Application  

 

ILLINOIS GAMING BOARD
160 North LaSalle Street, 3rd Floor
Chicago, Illinois 60601
312-814-4700

VIDEO GAMING
LOCATION LICENSE APPLICATION

Start here to begin a new application, or go to the Login page to continue an application in progress or to disclose any changes in the information previously provided to the Illinois Gaming Board.

Name of Location License Applicant (as registered with the Illinois Secretary of State):
Federal Employer Identification Number (FEIN):
Doing Business As (D/B/A):
Street address of premises to be licensed:
City / State / Zip Code:
County:
Local jurisdictions such as counties, villages and cities may prohibit video gaming. (see IL Local Governments) Is the proposed Licensed Video Gaming Location within a zone where Video Gaming Terminals are prohibited by local ordinance?

Jurisdictions are not required to inform the Illinois Gaming Board if they have passed ordinances banning video gaming, or if such restrictions were in place before the Act was passed. However, the Board strives to maintain a list of jurisdictions that prohibit such activity. Please examine closely the following list, and verify that the proposed Licensed Video Gaming Location is not within a listed jurisdiction. The proposed Licensed Video Gaming Location is within the following local jurisdiction:

If Applicant's address is in a municipality included on the video gaming banned list, applicant may only select 'None of the Above' if
1) The Applicant's address is OUTSIDE the corporate limits of the listed banned municipality, and
2) The Applicant's address is in an unincorporated area of a county that is NOT on the banned list.


Application for:


Applicant's Business Structure:






Authorized agent completing this form:
Agent relationship to Applicant:

Email address of Applicant*:
Re-enter email:
Email* CC to (separate multiple with comma):
* Communications relating to this application will be sent to these email addresses

New password**:
Re-enter password:
** Password must be between 8 and 50 characters long, include UPPER and lowercase, and include number or special characters.

I certify that I have read and understand the Instructions Page
I certify that I have read and understand the Definitions Page
Please read the investigative overview for locations.