What information and materials does the application request?

It requests establishment and owner information, employee certification and identification details, a five-year employment history, a statement about prior massage or similar businesses, and fingerprints.

How do I submit the massage establishment registration application?

The form names the Antioch Police Department at 300 L Street, Antioch, CA 94509. It lists initial registration fees of $350, renewal fees of $275, and $25 per employee.

Antioch, CA · Contra Costa County

No notary required

Massage Establishment Registration Application (Owner Without CAMTC Certification)

This application is for an Antioch massage establishment owner without CAMTC certification seeking initial registration or renewal through the Antioch Police Department.

What this form is

The application collects establishment and owner details, business type, employee CAMTC certification and identification information, and background-check materials. Owners applying for initial registration or renewal provide the requested information, attach owner identification and ownership details, and submit employment history, a statement about prior massage or similar businesses, and fingerprints as directed by the permit authority.

Who needs it

An owner without CAMTC certification seeking initial registration or renewal for a massage establishment in Antioch needs this application.

How to submit it

The form names the Antioch Police Department at 300 L Street, Antioch, CA 94509, and lists phone number (925) 778-2441. It lists initial registration fees of $350, renewal fees of $275, and $25 per employee.

About notarization

This application is signed without a notary; the applicant signs and dates a declaration under penalty of perjury and signs and dates the information-release authorization.

How to submit this form

1
Download The Application
Download the Massage Establishment Registration Application for an owner without CAMTC certification.
2
Complete The Application
Fill in the establishment and owner information, select the business type, and complete the applicable sections.
3
Gather Attachments
Attach owner information and identification, employee certification and identification copies, employment history, the prior-business statement, and fingerprints as directed.
4
Submit To The Police Department
The form names the Antioch Police Department at 300 L Street, Antioch, CA 94509, and lists registration and per-employee fees.

Frequently asked questions

Who uses this massage establishment registration application?: Massage establishment owners without CAMTC certification use it to apply for initial registration or renewal in Antioch.
What information and materials does the application request?: It requests establishment and owner information, employee certification and identification details, a five-year employment history, a statement about prior massage or similar businesses, and fingerprints.
Do I need a notary for this massage establishment registration application?: No. The application has no notary block; the applicant signs and dates a declaration under penalty of perjury and an information-release authorization.
How do I submit the massage establishment registration application?: The form names the Antioch Police Department at 300 L Street, Antioch, CA 94509. It lists initial registration fees of $350, renewal fees of $275, and $25 per employee.

Need something notarized?

This Massage Establishment Registration Application (Owner Without CAMTC Certification) doesn’t need a notary — but if you have another Antioch form that does, a commissioned online notary can help.