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.
At a glance
- Issued by
- City of Dayton · Dayton, Liberty County, Texas
- Notarization
- Not required: file this form without a notary.
- Official source
- cityofdaytontx.com
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
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.