Laserfiche WebLink
<br />REC'D J ie, N 2 1 2009 <br /> <br /> <br />13 Gun Secondary Raffle <br /> <br />I.... Pri~tf<:>:rr:n' <br /> <br />~jnnesota Lawful Gambling <br /> <br />Page 1 of 2 6/07 <br /> <br />LG220 Application for Exempt Permit For Board Use Only <br />An exempt permit may be issued to a nonprofit organization that: Fee is $50 for Check # <br />. conducts lawful gambling on five or fewer days, and <br />. awards less than $50,000 in prizes during a calendar year. each event $ <br />ORGANIZATION INFORMATION <br />Organization name Previous gambling permit number <br />Isanti Chapter of Minnesota Deer Hunters Association X - 0.,,;11 tJ.- C?J"- OO~2 <br />iypeof nonprofit organization. Check (..J) one. <br />o Fraternal o Religious o Veterans [lEI Oth~r nonprofit organization <br />Nailing address I City State/Zip Code County <br />205-1st Ave. East Cambridge MN. 55008 Isanti <br /> . <br />J'Jame of chief executive officer (CEO) Daytime phone number <br />John Erlandson. JJftSf 'l'R-E$f bt::u.JC-;- 763-689-4992 <br /> ./ <br />ATTACH A COPY OF ONE OF THE FOLLOWING FOR PROOF OF NONPROFIT STATUS <br />"* Do not attach a sales tax exempt status or federal ID employer numbers as they are not proof of nonprofit status. <br />. _ NonprofitArticles of Incorporation OR a current Certificate of Good Standing. <br /> Don't have a copy? This certificate must be obtained each year from: <br /> Secretary of State, Business Services Div., 180 State Office Building, St. Paul, MN 55155 Phone: 651-296~2803 <br />_ Internal Revenue Service - IR~ income tax exemption [501 (cll letter in your organization's name. <br /> Don't have a copy? To obtain a copy of your federal income tax exempt letter, send your federallD number and <br /> the date your organization initially applied for tax exempt status to: <br /> IRS, P.O. Box 2508, Room 4010, Cincinnati,OH 45201 <br />_Internal Revenue Service -Affiliate of national, statewide, or international parent nonprofit organization (charter) <br /> If your organization falls under a parent organization, attach copies of both of the following: <br /> a. IRS letter showing your parent organization is a registered nonprofit 501(c) organization with a group ruling <br /> b. . the charter or letter from your parent organization recognizing your organization as a subordinate. <br />o Internal Revenue Service. proof previously submitted to Gambling Control Board <br /> If you previously submitted proof of nonprofit status from the Internal Revenue Service, no attachment is required. <br />GAMBLING PREMISES INFORMATION <br />Name of premises where gambling activity will be conducted (for raffles, list the site where the drawing will take place) <br />Armstrong Ranch/Game Fair <br />Address (do not use PO box) Ic~ I Zip Code I County <br />8404-161st Ave. NW 1~4MS€ Y 55303 Anoka <br />Da4i~ of activity (for raffles, indicate the date of the drawing) <br />. - 'fi.6'uS'r J b ~ Of') OJ <br />Check the box or boxes ttfat indicate th~ type of gambling activity your organization will conduct: <br />o *Bingo IIEI Raffles 0 *Paddlewheels o *Pull-Tabs 0 *Tipboards <br /> * Gambling equipment for pull-tabs, tipboards, paddlewheels, and bingo (bingo paper, <br /> hard cards, and bingo number selection device) must be obtained from a distributor <br /> licensed by the Gambling Control Board. To find a licensed distributor, go to <br /> www.gcb.state.mn.us and click on List of Licensed-Distributors, or call 651-639-4076. <br /> <br />-8~ <br />