Maryville, IL · Madison County
Video Gaming Terminal License Application
Businesses use this application to request Village of Maryville licenses for video gaming terminals located at their establishment.
What this form is
This application requests Village of Maryville licenses for video gaming terminals at a business. It asks for applicant, business, terminal, manager or agent, and establishment-owner information, including the names and birth dates of owners with at least five percent interest. Applicants list supporting documents, certify licensing and permit information, and include the required fee with the application.
Who needs it
A business seeking Village of Maryville licenses for video gaming terminals at its establishment should complete this application.
How to submit it
Submit the completed application with the nonrefundable $25-per-terminal fee to the Village Clerk at 2520 N. Center, Maryville, Illinois, as shown on the form.
About notarization
This application is signed and dated without a notary; it lists supporting attachments but does not require a notarized attachment or sworn statement.
How to submit this form
- 1
Download The Application
Download the Video Gaming Terminal License Application.
- 2
Complete The Application
Print in blue or black ink and provide the requested applicant, business, terminal, manager or agent, and owner information.
- 3
Gather The Listed Attachments
Include the supporting information and documents listed on the form, along with the nonrefundable $25-per-terminal fee.
- 4
Submit To The Village Clerk
Submit the completed application to the Village Clerk at 2520 N. Center, Maryville, Illinois.
Frequently asked questions
- What does the Video Gaming Terminal License Application request?
- It requests Village of Maryville licenses for video gaming terminals and collects applicant, business, terminal, manager or agent, and qualifying establishment-owner information.
- What should I include with the application?
- The form lists terminal identification information, evidence of Illinois Gaming Board licenses for the terminal and establishment owners, liquor license information, food-service permit or compliance documentation, a terminal layout diagram, and the fee.
- Do I need a notary for the Video Gaming Terminal License Application?
- No. The application is signed and dated without a notary; it lists supporting attachments but does not require a notarized attachment or sworn statement.
- How do I submit the Video Gaming Terminal License Application?
- Submit the completed application and nonrefundable $25-per-terminal fee to the Village Clerk at 2520 N. Center, Maryville, Illinois.