Avenue North, Texas City, TX 77590-7407
www.texas-city-tx.org (409) 948-2525
TEXAS CITY POLICE DEPARTMENT
tach additional pages if more than one owner of the business, owns 25% or more.
opy of the applicants’ DBA, if applicable
a previous license or permit of applicant, or, if applicable, corporate officer or partner of applicant, has
been revoked with two (2) years of filing of the application.
ber of amusement redemption machines at the above given address. __________.
Name, Address and Telephone Numbers of all owner(s) of machines:
Business Name of Vending Company:
Address of Vending Company:
Telephone Number(s) of Vending Company:
State Vending Permit Number of License:
List all Amusement Redemption Machines that are to be used on the premises:
(Additional pages may be added)
Application for Coin Operated Amusement Redemption Machine
FRAUDULENT / FALSE INFORMATION WILL RESULT IN IMMEDIATE DISQUALIFICATION
(Illegible and/or incomplete applications will be denied)
rmit / License