203 S Troy St, Royal Oak, MI, 48067, US
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.
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: ___________________________________________________________
Other names (to include all nicknames, maiden names, and/or aliases) ________________________
Mailing address if different: ___________________________________________________________
Date of Birth: ______________________________________________________________________
Eye Color: ________________________________________________________________________
Hair Color: ________________________________________________________________________
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
Official Signing of Application – City of Royal Oak
I, _______________________________________________ of
Name and Title of Official
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.
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: ________________________________________________________________________
Driver’s License Number (State): ______________________________________________________
Other names by which I am known or have used in the past: ________________________________
Signature ________________________________________________ Date ___________________
Please upload your background information consent form here.
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 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.
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.
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
Please upload a copy of your driver's license here.
Please upload a passport photo (color) taken within the past 60 days - 2X2 inch size (head and shoulders)
Once you submit your application, it will be reviewed to be sure that all information fields are complete.