Who uses the Vending Machine License Renewal Form?

A business seeking renewal for cigarette vending machines or coin-operated amusement devices uses this form to provide applicant, business, and machine information.

How do I submit the vending machine license renewal?

Complete the application and return it to the City Manager with the proper fee. The form calculates the amount by multiplying the total number of machines and devices by $25.00.

What information does the renewal form request?

It asks for business and applicant details, felony-conviction information, owner or servicer details when applicable, machine counts, and the applicant's signature and date.

Do I need a notary for the Vending Machine License Renewal Form?

No. This form is signed and dated without a notary, and it lists no notarized or sworn attachment.

Mascoutah, IL · St. Clair County

No notary required

Vending Machine License Renewal Form

Mascoutah businesses use this renewal application to report cigarette vending machines and coin-operated amusement devices and request renewal of their vending machine license.

What this form is

The form is a renewal application for a vending machine license covering cigarette vending machines and coin-operated amusement devices. Applicants provide business and personal details, machine counts, and information about an owner or servicer if different from the applicant. The form says to return it to the City Manager with the proper fee and includes a Police confirmation section.

Who needs it

A business seeking to renew its Mascoutah vending machine license for cigarette vending machines or coin-operated amusement devices needs this form.

How to submit it

Return the completed application to the City Manager with the proper fee. The form calculates the amount using the total number of machines and devices multiplied by $25.00.

About notarization

This renewal form is signed and dated without a notary; it lists no notarized or sworn attachment, so the applicant just signs and dates it.

How to submit this form

1
Download The Form
Download the Vending Machine License Renewal Form.
2
Complete The Application
Enter the business and applicant information, answer the requested questions, and report the applicable machine counts.
3
Calculate The Proper Fee
Use the form's calculation: total machines and devices multiplied by $25.00.
4
Sign And Date
Sign and date the application to affirm that the information is true and correct.
5
Return It To The City Manager
Return the completed application to the City Manager with the proper fee.

Frequently asked questions

Who uses the Vending Machine License Renewal Form?: A business seeking renewal for cigarette vending machines or coin-operated amusement devices uses this form to provide applicant, business, and machine information.
How do I submit the vending machine license renewal?: Complete the application and return it to the City Manager with the proper fee. The form calculates the amount by multiplying the total number of machines and devices by $25.00.
What information does the renewal form request?: It asks for business and applicant details, felony-conviction information, owner or servicer details when applicable, machine counts, and the applicant's signature and date.
Do I need a notary for the Vending Machine License Renewal Form?: No. This form is signed and dated without a notary, and it lists no notarized or sworn attachment.

Need something notarized?

This Vending Machine License Renewal Form doesn’t need a notary — but Illinois residents can notarize other documents online with a commissioned online notary.