Tobacco License Application - Oswego Illinois

100 Parkers Mill, Oswego, Illinois 60543
630.554.3618 • Fax: 630.554.3306
Website: http//www.oswegoil.org
VILLAGE OF OSWEGO, KENDALL COUNTY, ILLINOIS
APPLICATION FOR TOBACCO LICENSE
Please Return Completed Application to Village Clerk
License Fee: $50.00/Year
License Period May 1 through April 30 of the following year
A separate license shall be required for each point of sale
DATE OF APPLICATION:
1. NAME OF ESTABLISHMENT:
2. ADDRESS OF ESTABLISHMENT:
Business Telephone No.:
3. Illinois Municipal Retailer’s Use and Service Occupation Tax Number registered to an address in
the Village of Oswego:
4. TYPE OF SALES:
A. Over the Counter Sale of Tobacco Products: ______Yes ______No
B. Vending Machine Sale of Tobacco Products (only allowed if Vending Machine was in place
before May 1, 2006) ______Yes ______No
5. APPLICANT INFORMATION:
Owner/Proprietor of Establishment:
Home Address:
Home Telephone Number:
Manager of Establishment:
Home Address:
Home Telephone Number:
6. Owner or Agent for Building:
Business Address:
Business Telephone Number:
Note: If Applicant is a corporation, give full name and address of registered agent.
Village of Oswego Code of Ordinances 3-19-5: Sales by Minors:
It shall be unlawful for any licensee, or its agent, director, manager, employee, officer or representative, to
permit any staff member under eighteen (18) years of age to sell tobacco products in any licensed premises.

TOBACCO LICENSE APPLICATION FOR:
STATE OF ILLINOIS )
) ss
KENDALL COUNTY )
being first duly sworn deposes and says that
has read the above and foregoing Application, caused the answers to be provided thereto, and all of the
information given by
on said Application is true and correct.
Signature of Applicant
Subscribed and sworn to before me, this day of , A.D. 20__
Print Name
Notary Public
NOTE: In the event Applicant is a partnership, the Application should be signed and sworn to in the same
manner by all partners.
In the event Applicant is a corporation, the Application should be signed and sworn to by the officers
and the local manager.
Village of Oswego
Tobacco License Application
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