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2. Business Name:*
3. Account No.:*
4. License No.:
6. Business Update:*

   1. NO BUSINESS CHANGES, ALL INFORMATION IS CURRENT - Skip to signature area below
   2. THE BUSINESS HAS NEW CONTACT INFORMATION OR CHANGES - Continue to section 2 & 3
   3. THE BUSINESS HAS SOLD - Continue to section 2
   4. THE BUSINESS HAS MOVED OUT OF WAUKEGAN
   5. THE BUSINESS HAS CLOSED
   6. THE PROPERTY IS NO LONGER RENTAL
   7. OTHER (please explain - i.e. Added Food & Bev / Added video gaming/ Added vending machines)
8. AS OF DATE:*
   AS OF DATE:
9. Please explain: *
   i.e. Added Food & Beverage / Added Video Gaming / Added Vending Machines
11. SECTION 2 - BUSINESS INFORMATION
13. New Business Name:
14. New Sq. Ft.:
16. New Business Location:
18. New Business Phone:
19. Website:
21. New Business Type:
    -- Select One --CorporationLLP/LLCSole ProprietorNon-Profit
22. Home Based:

    1. Yes
    2. No
24. SECTION 3 - OWNER INFORMATION / RESPONSIBLE PARTY
26. New Owner Name and Title
28. Address1
30. City
31. State
32. Zip
34. Owner Phone:
35. E-Mail:
37. New Contact Name and Title (other than owner):
39. Contact Phone:
40. Contact E-Mail:
42. Preferred Mailing Address
44. The signatory below certifies that to the best of his/her knowledge all the foregoing information is true and correct as provided.
46. E-Mail*
47. Signature:*
48. Date:*
    Date:
50. NOTE: Business Licenses are due each calendar year by December 31st. There is a 10% late fee after invoice due date. You may contact us at the Finance Licensing Department, (847) 360-0334, with any questions you may have.
    E-mail: BusinessLicensing@WaukeganIL.gov
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52. 1. Receive an email copy of this form.
53. Email address

    This field is not part of the form submission.

54. Submit

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