Dayton, TX · Liberty County
Coin Operated Machine Operator Application
Machine owners use this application to provide business and location details, list coin-operated machines, and record the annual occupation tax payment.
What this form is
The application records information about the machine owner’s business, one machine location, and each machine at that location. It includes a payment section stating $15 per year per machine, from January 1 through December 31, and an agreement affirming that the submitted facts are true and complete. The form states that Dayton requires an annual occupation tax for coin-operated machines as defined in Ordinance #2010-02.
Who needs it
A coin-operated machine owner applies for each location, providing the business, location, payment, and machine information requested.
How to submit it
Email the completed form to [email protected]. The form says to list additional machines on a new page.
About notarization
This application is signed and dated without a notary; the signer affirms the information is true and complete.
How to submit this form
- 1
Download The Application
Download the Coin Operated Machine Operator Application PDF.
- 2
Complete The Application
Fill in the owner, business, one location, payment, and machine details requested.
- 3
List Additional Machines
If there are more machines than the form lists, provide their information on a new page.
- 4
Email The Application
Email the completed form to [email protected].
Frequently asked questions
- Do I need a notary for the Coin Operated Machine Operator Application?
- No. The application is signed and dated without a notary; the signer affirms that the information is true and complete.
- How do I submit the application?
- Email the completed application to [email protected], as directed on the form.
- What information does the application request?
- It requests owner and business details, one machine location per application, payment information, and each machine’s type, make and model, and serial number.
- What if I have more machines than the form lists?
- The form says to list additional machines on a new page.
Need something notarized?
This Coin Operated Machine Operator Application doesn’t need a notary — but Texas residents can notarize other documents online with a commissioned online notary.