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City of Royal Oak, MI

203 S Troy St, Royal Oak, MI, 48067, US

Massage Establishment License Application

City of Royal Oak Code:  Chapter 447

The undersigned hereby applies to the city of Royal Oak for  a license to conduct business. In support of this application, the following representations are made: 

Applicant mailing address

Business will be conducted under one of the following types of organization:

Is the business location(s) owned by the applicant, or leased?

Name of owner/lessor:

Address of owner/lessor:

Mailing address of parent company, if any:

Is the applicant or any of its affiliates currently conducting business outside the City of Royal Oak (including other states)?

Is the applicant, or any business entity controlled by the applicant currently conducting business within the City of Royal Oak?

Please upload a Certificate of Good Standing issued by the State of Michigan.

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If a partnership, indicate city / town / state of partnership:

Has the applicant or any of its affiliates, directors, manager, or officers even been the subject of any civil proceeding by an federal, state, county or municipal authority challenging its ability to engage in business?

Has the applicant or any of its affiliates, directors, a manager, or officers ever been refused a license to engage in business or had any license revoked or suspended in any state or municipality?

Business, Occupation or Employment Record

Furnish a complete record of business, occupation, or employment for the last 10 years immediately preceding the date of application. 

NOTE: all periods of time must be accounted for, periods of unemployment should be indicated and dates given. (including name, address & telephone number of all employers)


NOTICE:  The City of Royal Oak reserves the right to request additional information from the applicant.

Personal Disclosure Statement - City of Royal Oak

Information as indicated herein is requested to be filed by every officer, director, or owner of 10% or more of the stock of a corporate applicant, by every partner of a partnership applicant, by the owner when the application is a sole proprietorship, and certain employees of businesses as mandated by City Ordinance. A separate form is to be filed by each person. The information indicated must be furnished fully and in detail. Separate exhibits should be attached when space provided is not sufficient to set forth the information completely.

Omissions will be constructed as an intentional failure to disclose a material fact and will be sufficient grounds for denial.

The following information is furnished by the undersigned in conjunction with and is made a part of the application of:


Applicant Business Name: ___________________________________________________________

Name: ___________________________________________________________________________

Other names (to include all nicknames, maiden names, and/or aliases) ________________________

Residence Address_________________________________________________________________



Mailing address if different: ___________________________________________________________



Date of Birth: ______________________________________________________________________

Height: ___________________________________________________________________________

Weight: __________________________________________________________________________

Eye Color: ________________________________________________________________________

Hair Color: ________________________________________________________________________

Sex: _____________________________________________________________________________

Social Security Number: _____________________________________________________________

Driver License Number (State): ______________________  Number: _________________________

Telephone Number: ________________________________________________________________


Click here for a blank form to print and fill out.

Please upload a personal disclosure statement for EACH person listed above

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Official Signing of Application – City of Royal Oak


I, _______________________________________________   of

Name and Title of Official


Applicant Name

a corporation organized in the State of ____________________   do hereby declare

that I am duly authorized to file the foregoing application and that the statements and

representations set forth therein are true to the best of my knowledge and belief.


And ACKNOWLEDGE that the City of Royal Oak, its agents and employees are

authorized to seek information and conduct and investigation into the truth of the

 statements set forth in this application and that I am required to provide such

additional information as may be requested of me.



Authorized Signature                                                                          Title







STATE OF     _________________________________

COUNTY OF _________________________________

Subscribed and sworn to before me, a Notary Public in and for said County, on

this _________________   day of __________________,   ________________.



Signature of Notary Public

A Notary in and for _____________________________ County

State of ______________________________________                                               

My commission expires:   ________________________


You can download a blank form here to use.

Please upload your notarized affidavit.

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Background Information Consent Form   

 City of Royal Oak


By signing the Consent, I understand and agree to the following:

The following information about me is necessary to assist the City of Royal Oak in evaluation the application of  _____________________________________________________________________.

The information will be used to evaluate, among other things, my experience, character, business reputation, general fitness, and suitability to conduct business as legally required by Ordinance 425 (with any amendments) of the City of Royal Oak.

I understand that omissions or inaccuracies in completing the application may result in denial of the application. The City of Royal Oak may also conduct an independent investigation of me which may include, but not limited to, contacting federal and state law enforcement agencies. If any information the City of Royal Oak received indicates a violation of law, the information will be shared any agency responsible for investigating or prosecuting the violation.

If the information about me would warrant denial of the application, the City of Royal Oak will give the applicant, through the person designated for contact, notice of that fact, including a statement of the legal and/or factual basis which would warrant denial and applicant’s rights in respect thereto.


Full Name: ________________________________________________________________________

Address: _________________________________________________________________________


Telephone Number: ________________________________________________________________

Social Security Number: _____________________________________________________________

Driver’s License Number (State): ______________________________________________________

Date of Birth: ______________________________________________________________________

Other names by which I am known or have used in the past: ________________________________



Signature ________________________________________________ Date ___________________



Click here for a blank form to print and fill out.

Please upload your background information consent form here.

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Authorization to Release Information

City of Royal Oak



I, _______________________________, whose residence address is _________________________


am making application to conduct business in the City of Royal Oak at: _________________________________________________________________________________

Name and address where business in the business will be conducted.

I hereby give my consent and permission to release any record, report, or information pertinent I may have to the City of Royal to obtain a business license.


Date: ______________________________________________

Signature: __________________________________________

Date of Birth: ________________________________________

Social Security Number: _______________________________


The person whose signature appears above personally appeared before the undersigned, a Notary Public in and for the above named County and State, the day and date named, and acknowledged the execution of the foregoing instrument to be the voluntary act and deed of the applicant therein named and for the purposes therein set forth, that they are duly authorized to execute the instrument, and that the statements and representations therein contained are true to the best of their knowledge and belief.



Signature of Notary Public

A Notary in and for ______________________________ County

State of _______________________________________                                             

My commission expires:   _________________________


Click here for a blank form to print and fill out


Please upload your notarized authorization to release information form here.

Click Here to Upload

Criminal Offenses

Please list all criminal convictions other than misdemeanor traffic violations, including the dates of convictions, nature of the crime and place convicted.

If the application is a corporation or limited liability company, the names and residence addresses of each of the officers, directors and members of the business and of each stockholder, its address (if different from the address of the massage establishment), and the name and address of a resident agent in Oakland County, Michigan.

You will have to obtain a criminal background check from the Michigan State Police Department  by going to the website:


You will have to enter a credit or debit card number for the $10 fee. Attach the results and submit with this application.


Please upload a copy of your ichat report here

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Please upload a copy of your driver's license here.

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Please upload a passport photo (color) taken within the past 60 days - 2X2 inch size (head and shoulders)

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Once you submit your application, it will be reviewed to be sure that all information fields are complete. 

Once the review is complete, you will be emailed a payment link for the non-refundable $1000 application fee. 
Upon receipt of payment, your application will be sent for review. You will be contacted upon approval or denial.

Applicant's Signature

Choose how to sign

For office use only