Illinois State Seal
Illinois Gaming Board  
Video Gaming Location License Application  


8. RELEASE OF INFORMATION

The Applicant must submit both a signed
IGB APPLICANT REQUEST TO RELEASE INFORMATION  form (for the location Applicant)
 and an
AUTHORIZATION TO RELEASE TAX INFORMATION  form (for the location Applicant)
to enable the Illinois Gaming Board to investigate this Application.

Sign and submit a scanned PDF copy of the IGB Applicant Request to Release Information  below:



Sign and submit a scanned PDF copy of the Authorization to Release Tax Information  below:




As part of the background investigation for the location license, identified below are Individuals and Business Entities that are required to sign, have notarized, and submit a PDF copy of the REQUEST TO RELEASE INFORMATION  form (for Individuals and Business Entities).