Amusement Device Application
Amusement Device License Application — Borough of Ebensburg
This is a blank application form for an Amusement Device License issued by the Borough of Ebensburg, Pennsylvania. It is intended for individuals or businesses seeking to operate amusement devices (e. g. , arcade games, carnival rides, etc. ) within the borough.
Required Information Fields:
- Name of Business
- Contact Name
- Mailing Address (two lines provided)
- Telephone Number
- Property Owner (if different from applicant)
- Location of Devices
- Location Being Held
Device Description Section:
Applicants must list each machine or device with:
- Identification #
- Type Of Machine
- Features
(Three blank rows are provided for entries. )
Additional Information:
A section with four blank lines is available for any extra notes or disclosures.
Signature Block:
At the bottom, applicants must provide:
- Name of Applicant
- Signature of Applicant
- Date
Important Note:
The form directs users to “SEE REVERSE” for important instructions — though the reverse side is not included here.
Contact Information for Borough of Ebensburg
For questions or submissions, contact:
Borough of Ebensburg300 West High StreetEbensburg, Pennsylvania 15931Phone: 814-472-8780Fax: 814-472-8789Email: eburg@ebensburgpa. com
⚠️ Reminder: Always check the reverse side of the form for additional requirements or instructions before submitting.