Amusement Device Application
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Overview
This document is an application form for an Amusement Device License issued by the Borough of Ebensburg, Pennsylvania. It is designed for business owners or operators to register their amusement devices and provide necessary contact and location details.
Required Information
Applicants must complete the following fields:
- Business Details: Name of Business, Contact Name, Mailing Address, and Telephone Number.
- Property Details: Name of the Property Owner (if different from the applicant), Location of Devices, and the specific Location Being Held.
- Device Description: A detailed list including the Identification Number, Type of Machine, and Features for each device.
- Additional Information: A section for any extra notes or details.
Submission Requirements
To finalize the application, the following must be provided at the bottom of the form:
- Name of Applicant
- Signature of Applicant
- Date
Contact Information
The form directs applicants to see the reverse side for important information. The Borough of Ebensburg contact details are:
- Address: 300 West High Street, Ebensburg, Pennsylvania 15931
- Phone: 814-472-8780
- Fax: 814-472-8789
- Email: eburg@ebensburgpa. com