Each required document will have an attachment option next to it. If there is no attachment option next to one of these documents, you do not need to provide it.
Proof of FEIN or SSN
This must be the Notice of New Federal Employer Identification Number Assigned or a recent tax form or correspondence from the Internal Revenue Service that verifies the FEIN, or for Sole Proprietorships, a copy of the Social Security Card of the sole owner.
Owners' Proofs of Identity
A copy of the state-issued driver's license or identification card must be provided for each owner.
Health Inspection Report or Business License
A copy of the most recent health inspection report within the past 12 months or the current business license demonstrating all requirements to operate a retail grocery store authorized to sell perishable foods have been met.
Proof of SNAP Authorization
A copy of the SNAP Authorization permit that was issued by USDA FNS, which lists the store name, address, and SNAP Authorization Number.
Bill of Sale
A legal document that verifies the date of purchase or acquisition of the business entity.
Out of State / Country Proof of Incorporation
Copy of Articles of Incorporation duly authenticated by the proper officer of the state or country where the corporation is incorporated.
Current Pharmacy License
If you are applying as a store-type pharmacy or grocery store with a pharmacy, you must provide proof of the current and active pharmacy license issued by the Illinois Department of Financial and Professional Regulations (IDFPR). Information can be found online at www.idfpr.illinois.gov.
Additional Owners Names and Proofs of Identity
If you responded Three (3) or more to the question "How many partners, limited partners, shareholders, owners, or officers are in the Ownership?" you must attach a document listing the following information: Full Name. Driver's License or State ID Number, Home / Cell Phone Number, Home Address including city, state & zip, and the percentage of the business that this person owns. You must also attach a copy of this person's state-issued driver's license or ID.
Qualifying Questions
If you responded "yes" to any questions 5 - 11 in Section 6 - Qualifying Questions, please explain why the response was yes, who is involved, and any necessary documentation.
Previous Stores
If you responded "yes" to the question "Have any owners/partners/shareholders/managers previously owned or operated another grocery store or pharmacy in Illinois?" please provide a list of the names and addresses of the stores that were previously owned and the years that they were owned or operated.
