What information does the Amusement Machine License Application request?

It asks for the machine owner’s contact information, the name and address of the establishment, and the types and numbers of machines at that location.

Do I need a notary for the Amusement Machine License Application?

No. The application has no notary block and states no sworn step or attachment requiring notarization.

How do I submit the Amusement Machine License Application?

Complete the application and return it to the Office of the City Clerk at 55 West Maiden Street, Washington, PA, with a check in the appropriate amount.

What fees does the application list?

The application lists 2025 fees of $100 for each jukebox and $350 for each other machine. It also states a December 2, 2024 due date.

Washington, PA · Washington County

No notary required

Amusement Machine License Application

Machine owners use this application to report their contact information, the establishment where machines are located, and machine types and counts.

What this form is

The City Clerk’s Amusement Machine License Application collects owner contact details, the establishment’s name and address, and counts by machine type for a location. The form says to complete it in full and return it with a check; it lists 2025 fees of $100 per jukebox and $350 per other machine, and states a December 2, 2024 due date.

Who needs it

An amusement machine owner uses this application to report the establishment location and the types and numbers of machines there.

How to submit it

Return the completed application to the Office of the City Clerk, 55 West Maiden Street, Washington, PA, with a check in the appropriate amount.

About notarization

No notary is required; the document has no notary block and asks for owner, establishment, and machine information, with no attachment or sworn step stated.

How to submit this form

1
Download The Application
Download the Amusement Machine License Application PDF.
2
Complete The Application
Provide the owner’s contact details, establishment information, and the number of each machine type at the location.
3
Prepare The Check
The form says to include a check in the appropriate amount; it lists fees for jukeboxes and other machines.
4
Return It To The City Clerk
Return the completed application and check to the Office of the City Clerk, 55 West Maiden Street, Washington, PA.

Frequently asked questions

What information does the Amusement Machine License Application request?: It asks for the machine owner’s contact information, the name and address of the establishment, and the types and numbers of machines at that location.
Do I need a notary for the Amusement Machine License Application?: No. The application has no notary block and states no sworn step or attachment requiring notarization.
How do I submit the Amusement Machine License Application?: Complete the application and return it to the Office of the City Clerk at 55 West Maiden Street, Washington, PA, with a check in the appropriate amount.
What fees does the application list?: The application lists 2025 fees of $100 for each jukebox and $350 for each other machine. It also states a December 2, 2024 due date.

Need something notarized?

This Amusement Machine License Application doesn’t need a notary — but if you have another Washington form that does, a commissioned online notary can help.