The following documents are required to be up-to-date and on file at all times during the license period, and must be included with your application submission:

1. List of Owners, Partners, Officers, etc.
   • Must include the Name, Date of Birth, Address, Email Address, and Percent Owned for each
2. A document detailing the Establishments where devices will be located, which includes only the following:
   • Legal Entity Name of the business;
   • DBA/Assumed Name of the business, if applicable;
   • Complete address of the business, including suite, unit, etc. numbers; and
   • Total number of devices that will be at that specific location.

   As a reminder, device details are not required. Please only submit the information requested above.

The following information is reviewed internally, so applicants should not submit the following unless specifically requested.

1. If applicable, entities must be in good standing with the State of IL. No documentation should be submitted from the business for this. The City Clerk Department will verify standing directly with the State of IL.
2. DBA/Assumed Name must be registered – If the Applicant will use a different name with the public than the name of the legal entity, the DBA/Assumed Name must be registered with the State of IL or McLean County:

NOTE: If already registered, this documentation is not required for submission and will be monitored internally. If not registered, please complete one of the following:

1. State of IL Adoption of an Assumed Name (Corporations and LLCs): OR
2. McLean County DBA/Assumed Name Registration 

This application is intended for Amusement Device Owner licensees that hold an existing license with the City of Bloomington and wish to update the number of devices currently listed on their license.

A device update application must only be submitted for the following reasons:

1. The number of devices has increased from the number listed on your license; and/or
2. The number of devices has not changed as a whole, but the number at a specific location has shifted (for example: moving devices from one location to another)

For renewals, which are billed the first week of March each year:

If the # of devices and device locations on your current license will remain the same, please do not complete the form below. Your account will be billed for the existing amount.

Please complete the form below to notify the City of changes in the total number of devices or device locations to be billed.

Application for Verification of Amusement Devices (For Renewals Only)

The above form must be submitted at least 2 weeks prior to the renewal date (1st business day in March each year) to ensure the device number is adjusted for your upcoming license renewal.

NOTE: If the application is not received by the deadline, the account will be billed for the existing number of devices. 

Application Process

1. Once an application is submitted, staff will review and reach out to the applicant via email if any additional information is needed.
2. Once review is complete, the City Clerk Department will modify the account to reflect the requested number of total devices.
   • The amount will be reflected on the renewal invoice sent to the licensee when the renewal period begins.

Required Supplemental Document

• A document detailing the Establishments where devices will be located, which includes only the following:
  • Legal Entity Name of the business;
  • DBA/Assumed Name of the business, if applicable;
  • Complete address of the business, including suite, unit, etc. numbers; and
  • Total number of devices that will be at that specific location.

As a reminder, device details are not required. Please only submit the information requested above.

Before license application review can begin, the applicant must pay the following Application Fee:

Application Fee: $100

If approved and before a license can be issued, the following License and Device Fees must be Paid:

Annual License Fee: $250
Annual Device Fee (per approved device): $75

Note that the applicant will not be required to pay license and vehicle fees unless approved.

For an applicant's first annual license with the City Clerk Department, the license and vehicle fees will be prorated based on the number of days remaining in the active term following approval.