Form Center

2. I/We, the undersigned, hereby make application for license under and by virtue of the Ordinances of the Village of Riverside for conducting a business.
4. Name of Business
6. D/B/A Name
8. Type of Business

   1. Corporation
   2. Partnership

   1. Sole Proprietor
   2. Other
10. Federal Tax ID #
11. IL Retail Sales Tax # **
12. Zoning District
14. Address
16. City
17. State
18. Zip Code
20. Phone Number
21. Fax #
22. Email
24. Hours of Operation
25. Business Website
27. Detailed Profile of Business & All Services Rendered at this Location
29. Type

    1. Bowling Alley
    2. Christmas Tree Merchant
    3. Milk Distributor
    4. Filling Stations
    5. Multiple Locations
    6. Laundromats

    1. Moving Picture Theatre
    2. Any Retail Operations
    3. Catch Basin & Sewer Cleaners (Scavengers)
    4. Tobacco Sales
    5. Estate Sales

    1. Food Dealer***
    2. Secondhand & Antique Dealer
    3. Mobile Food Units (Push Carts or temporary trailers)
    4. Street & Sidewalk Sales
    5. Peddlers
31. ** Requires registration with the Illinois Department of Revenue *** Requires Health Inspection
33. ALL BUSINESSES WILL BE INSPECTED RELATIVE TO BUILDING AND FIRE DEPARTMENT CODES
    I/We hereby certify that all of the information contained in this application for a Business License is true and correct, that I/We am/are authorized to sign this document of behalf of this business; further that any false penalties provided for by law. I/We further state that we understand all of the ordinances of the Village of Riverside or the laws of the State of Illinois or of the United States of America in the conduct of the place of business described herein. NOTE: This is an application for a business license and it is understood that a business cannot be conducted until a license is issued by the Village Clerk of the Village of Riverside, Illinois.
35. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
37. Electronic Signature
Leave This Blank:


39. Submit

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