Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Adult Entertainment License Application

  1. City Clerk's Office

    (712) 328-4616

  2. Business Information

  3. Please attach a list of partners and/or corporation officers, state / date of incorporation.

  4. Attach a notarized statement as required by the city's Municipal Code - Section 3.15.070(c)7. Attach a copy of the lease or warranty deed.

  5. Manager Information

  6. Attach proof the owner and/or manager is at least 18 years of age.

  7. Please return payment of $250 by the renewal date of June 30th to:
    City Clerk
    209 Pearl St.
    Council Bluffs, IA 51503

  8. Leave This Blank:

  9. This field is not part of the form submission.