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2. Business License Application Form - Renewal
4. Instructions

   1. Complete the Renewal Application Form. 

   2. Submit electronically. You may print a copy for your records.

   3. You will be redirected automatically to the Licensing Payment Portal.

   4. Enter your License Type, License Number, Renewal Number exactly as it appears on your renewal notice.

   5. Submit electronic payment.

8. Business Information *

   Provide local business & corporate information

   1. Incorporated- Secretary of State
   2. Sole Proprietor- County
9. Corporate Name/ Sole Propietor*
10. Assumed Business Name/DBA*
12. Business License Renewal No.*
    This number is provided to you in your renewal form.
13. Business License No.*
    This number is provided to you in your renewal form.
14. IBT No./Retailer's Occupational Tax No. *
15. FEIN Number*
19. Do you own or lease the facility in which your business is located?*

    1. Own
    2. Lease
21. Upload a Copy of the Lease or Proof of Ownership*
23. Area of Business in Square Feet*
25. Type of Establishment*

    1. Food Establishment
    2. Service Establishment
    3. Retail and Wholesale Sales
    4. Multiple
27. Percent Food Establishment
    -- Select One --0%10%20%30%40%50%60%70%80%90%100%
28. Percent Service Establishment
    -- Select One --0%10%20%30%40%50%60%70%80%90%100%
29. Percent Retail and Wholesale Sales
    -- Select One --0%10%20%30%40%50%60%70%80%90%100%
31. Business Activity - Select one or more of the following activities associated with your business.*

    1. COVID-19 Testing
    2. Tobacco and/or Alternative Nicotine Product Sales
    3. Video Gaming/Gambling
    4. Alcoholic Beverage Sales
    5. Circus (no mechanical rides)
    6. Carnival (includes mechanical rides)
    7. Live Entertainment
    8. Animal Exhibition
    9. Billiards / Pool Tables
    10. Vendor - Nonpermanent Location
    11. Fuel Service Station
    12. Taxicab
    13. Automobile Sales
    14. Cannabis / Drugs - Items designed for or marketed for use with
    15. Vending Machines
    16. Amusement Devices
    17. Automatic Music Devices
    18. Public Dance

    1. Dealers of Secondhand Items
    2. Food Delivery Vehicles
    3. Food of Beverage Vending Vehicles
    4. Dry Cleaning Machines
    5. Theaters
    6. Bus Services
    7. Solicitors
    8. Coin-Operated Amusement
    9. Horse Stable
    10. Sidewalk Sale
    11. Rabbitry
    12. Tent Sales
    13. Hobby Kennels
    14. Massage
    15. Private Outdoor Pay Telephone
    16. Hotels and Motels
    17. NO ADDITIONAL ACTIVITIES
33. Tests Offered

    1. Rapid
    2. Laboratory
    3. Rapid and Laboratory
34. Method of Specimen Collection

    1. Staff administers test to collect specimen
    2. Patient self-collects specimen
36. How are Test Results Handled?

    1. Staff interpret and report test results
    2. Staff receive specimen and send to laboratory for interpretation and reporting of results
    3. Patient self-interprets their own results
38. Provide a copy of your CLIA Certificate or Proof of Application
40. Provide the Name of the Testing Laboratory Used
42. Tobacco license Required
    Renewal Tobacco License

    A separate tobacco license is required.  These licenses are issued by the Village Clerk.  Please follow the above link to open a separate window to apply for a tobacco license in addition to your business license.

44. Gaming License Required
    Contact the Clerk's Office

    A separate gaming license is required.  These licenses are issued by the Village Clerk.  Please follow the above link to open a separate window with contact information for the Clerk's Office.

46. Liquor License Required
    Contact the Clerk's Office

    A separate liquor license is required.  These licenses are issued by the Village Clerk.  Please follow the above link to open a separate window with contact information for the Clerk's Office.

48. Circus - Start/End
    Circus - Start/End Start Date

    —

    Circus - Start/End End Date
49. Carnival Start/End
    Carnival Start/End Start Date

    —

    Carnival Start/End End Date
50. Animal Exhibition Start/End
    Animal Exhibition Start/End Start Date

    —

    Animal Exhibition Start/End End Date
51. Billiards - Number of Tables
53. Vendor Start/End
    Vendor Start/End Start Date

    —

    Vendor Start/End End Date
54. Fuel - Number of Hoses
55. Taxicab - Number of Cabs
56. Vending Machine - Type
    -- Select One --CigaretteFoodBoth
58. Number of Food Machines
59. Public Dance Start/End
    Public Dance Start/End Start Date

    —

    Public Dance Start/End End Date
60. Dealer - Type
    -- Select One --ItinerantDealer and/or PawnbrokerLimited Sales Dealer
62. Itinerant Dealer Start/Stop
    Itinerant Dealer Start/Stop Start Date

    —

    Itinerant Dealer Start/Stop End Date
63. Food Delivery - Number of Vehicles
64. Food Vendor - Number of Vehicles
65. Dry Cleaning - Number of Machines
67. Theater Number of Seats
    -- Select One --1 to 600 seats601 to 1,000 seatsOver 1,000 seatsDrive-In Theater
68. Bus Service - Number of Buses
69. Solicitors - Number of Solicitors
70. Coin-Operated Devices/Centers
    -- Select One --Coin-Operated Amusement DeviceCoin-Operated Amusement CenterCoin-Operated Amusement Center-Restaurant
72. Coin-Operated Devices - Number of Machines
73. Sale - Duration
    Sale - Duration Start Date

    —

    Sale - Duration End Date
74. Rabbitry - Location
    -- Select One --Inside a DwellingInside an Accessory Structure
75. Pay Phone - Number of Phones
77. Hotel/Motel - Number of Rooms
78. Hotel/Model - Total Area of all Rooms in Square Feet
79. I certify that my business does not contain any additional activities
    -- Select One --Yes - I have read the full list
81. Provide a full description of your business and all related activities. Be specific! Insufficient answers may delay your registration*
83. Total Number of Employees*
84. What Percentage of Employees are Veterans?*
85. Is the Business Veteran-Owned?*

    1. Yes
    2. No
87. Total Number of Parking Spaces*
89. Hazardous Material Storage?*

    1. Yes
    2. No
91. Attach a list of all hazardous materials stored on site
92. Type of Food Service

    1. Pre-Packaged Foods
    2. Beverages
    3. Counter Service

    1. Sit-Down Dining
    2. Food Packaging or Processing
94. Days of Operation

    1. Sunday
    2. Monday
    3. Tuesday
    4. Wednesday
    5. Thursday
    6. Friday
    7. Saturday
    8. By Appointment Only
96. Sunday Open
    Sunday Open
97. Sunday Close
    Sunday Close
98. Monday Open
    Monday Open
99. Monday Close
    Monday Close
101. Tuesday Open
     Tuesday Open
102. Tuesday Close
     Tuesday Close
103. Wednesday Open
     Wednesday Open
104. Wednesday Close
     Wednesday Close
106. Thursday Open
     Thursday Open
107. Thursday Close
     Thursday Close
108. Friday Open
     Friday Open
109. Friday Close
     Friday Close
111. Saturday Open
     Saturday Open
112. Saturday Close
     Saturday Close
116. Preffered Mailing Address*

     1. Business Address
     2. Corporate Address
118. Business Address*
119. Phone Number *
121. City*
122. State*
123. Zip Code*
125. Corporate Address
126. Phone Number
128. City
129. State
130. Zip Code
134. Ownership – Principals, Sole Owners, Shareholders, Partners, etc.
     If you have additional, please attach the listing.
136. 1. Business Owner*
137. Email Address*
139. Address*
141. City*
142. State*
143. Zip Code*
145. Phone Number*
146. Cell Number*
148. 2. Business Owner
149. Email Address
151. Address
153. City
154. State
155. Zip Code
157. Phone Number
158. Cell Number
162. Key Holders/Emergency Contacts
     A minimum of (2) two contacts are required. Do NOT provide ownership info. as listed above.
164. 1. Key Holder*
     Cannot be owner information. Please provide alternative contacts.
165. Title*
166. Cell Phone Number*
168. 2. Key Holder*
     Cannot be owner information. Please provide alternative contacts.
169. Title*
170. Cell Phone Number*
174. Property Ownership
     Building Owner
176. Building Owner*
177. Email Address
179. Address
181. City
182. State
183. Zip Code
185. Phone Number*
186. Cell Number
188. Execute*

     1. I agree

     By selecting I agree option below you are giving your electronic signature.
189. No False statements
     Your submission of this form certifies that the information provided is true and correct.
191. First Name*
     Information for individual completing this form.
192. Title*
194. Phone Number*
195. Email Address*
Leave This Blank:


197. 1. Receive an email copy of this form.
198. Email address

     This field is not part of the form submission.

199. Submit Submit and Print

* indicates a required field