Agenda - Council - 08/22/2000 - Laserfiche WebLink

Home

Premises Permit Application - LG2'I4 Page 2 of 3 1t99 Bingo Occasions - for Class A or C Permits If applying for a class A or C permit, enter days and beginning~ending hours of bingo occasions (indicate A.M. or P.M.). No more than ten bingo occasions may be conducted per week. An occasion must be at least one and one-half hours, not to exceed four hours. Day 8eqinninqtEndinq Hours Day Beqinninq/Endinq Hours to to tO Gambling Bank Account Information Bank name Bank ad 8,.~e ss Bank account number' New organizations: The account number may be obtained and submitted lo the Gambling Control Board within ten days after you receive your premises permit. Name, address, and title of members authorized to sign checks from the gambling account. The organization's treasurer may not handle gambling funds. Name Address Acknowledgment Oath Title Gambling site authorization I hereby consent that local law enforcement officers, the board or agents of [he board, or the commissioner of revenue or public safety or agents of the commissioners, may enter the premises to enforce the law. Bank records information The board is authorized to inspecl the bank records of the gambling account whenever necessary to fulfill requirements of current gambling rules and taw. Organization license authorization I hereby authorize the Gambling Control Board to modify the class of organization license to be consistent with the ctass of permit being applied for. /'/-~~~ m aynotsign) I declare that 1. I have read this application and all information submitted lo the board is [rue, accurate, and complete; 2. all other required information has been fully disclosed; 3. I am the chief executive officer of the organization; 4. I assume full responsibility for the fair and lawful operation of all activities to be conducted; 5. I will familiarize mysetf with the laws of Minnesota governing lawful gambling and rules of the board and agree, if licensed, to abide by Hose laws and rules, including amendments t~ them; 6. any changes in application information will be submitted to the board and local unit of government within ten days of the change; and 7. I understand that failure to provide required information or providing false or misleading information may resuR in the denial or revocation of the license. Date I I' I I I I I I I I I I -114-