Video Gaming Location License Application

10. SUBMIT COMPLETED APPLICATION TO IGB

The following items must be included for your Application to be accepted:

1. Register page
      Verify that the Premises is not located in a jurisdiction where Video Gaming Terminals are prohibited
      Verify that the authorized agent and relationship has been provided

2. Applicant Info page
      Complete required information
      Submit a flowchart illustrating the fully diluted ownership of the Applicant

3. Business/Individual Interests page
      Account for 100% direct Ownership Interest of the Applicant
      Provide Video Gaming Manager information

For each Trust, disclose the Grantor, all Trustees and all Beneficiaries

You must complete the contact information for each IGB Requested PSIC.

4. Questions/Answers page
Answer required questions

Submit letter from the Internal Revenue Service (Not-for-profit/charitable organizations only)

5. Verification page
      Authorized Agent required

6. Release Of All Claims page
      Authorized Agent required

7. Acknowledgement page
      Authorized Agent required

8. Release of Information page
      Signed and notarized Applicant Request To Release Information
      Signed Authorization to Release Tax Information
      Signed and notarized Request to Release Information for Individuals and Business Entities

9. Disclosure of Records page
      Complete the Disclosure of Records '5.1 Information'

10. REQUIRED

By clicking Submit, I acknowledge and accept the following statements

Under Board Rule 1800.550, only complete applications will be considered for licensure. By submitting this application, the applicant certifies that the establishment and the location at which it plans to locate video gaming terminals are complete and ready for inspection. Applicant acknowledges that the application may be deemed incomplete if the application is submitted and the establishment and the location at which it plans to locate video gaming terminals is not complete and ready for inspection. Incomplete applications will be closed.
As a condition of application and licensure, the applicant consents to being served notices via email, including notices of proposed disciplinary action and final Board orders. Applicants must designate a primary email address, and may designate no more than two secondary email addresses. All email addresses must be updated as they are changed and verified annually.

You will be contacted by the Illinois Gaming Board when the investigation process begins.

You are required to keep the information (address, email, phone #s) up to date on this web site.

Please read the investigative overview for locations.

Illinois Gaming Board Video Gaming Location License Application

Illinois Gaming Board
Video Gaming Location License Application