In addition to the requirements set forth above, applications for a license to conduct a game room shall contain the following information:
(A) The name and address of the applicant’s business or, if a proposed business, the name and address of the proposed game room;
(B) If applicable, the date of the filing of the “assumed name” of the business with the County Clerk;
(C) A drawing of the proposed layout of the premises drawn to scale and showing the location of amusement devices, aisles, counters and other significant details;
(D) In case of co-partnership, the date of the formation of the partnership; in the case of an Illinois corporation, the date of its incorporation; or in the case before incorporation, the state where it was incorporated and the date of its becoming qualified under the Illinois Business Corporation Act, being 805 ILCS 5/1.05 et seq., to transact business in the state;
(E) If the applicant is an owner, the name and address of the proposed operator;
(F) If the applicant is an operator, the name and address of the proposed owner;
(G) Whether the applicant is an owner or operator of any other game room within the state and, if so, the name and address of such other operation;
(H) If the game room is not to operate as the principal business at the location, a statement as to the type of business which will be the principal business at the location in question;
(I) Whether the applicant is delinquent in the payment of any retailer’s occupation tax and, if so, the reasons therefor;
(J) Whether the applicant has made an application in another municipality for a liquor license or a game room license and whether such application has been denied and if so, the reasons therefor;
(K) Whether the applicant has ever been convicted of a gambling offense or felony and, if so, the particulars thereof; and
(L) The applicant’s name, sex, date of birth, Social Security number, position and percentage of ownership in the business; the name, sex, date of birth, Social Security number, position and percentage of ownership in the property if an owner, or in the business if an operator of every sole owner, partner, corporate officer, director, manager and any person who owns 5% or more of the shares of the applicant business entity or parent corporations of the applicant business entity. Where the applicant is a corporation or partnership, the answers to each question relating to this application shall be given with regard to any person who owns or controls an interest of more than 5% within the partnership or corporation.