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Lease Agreement Name and Address!of Lessor Address City/Zip Code Phone ~erne ol Le~'~,lOw~r~ ef Galling Pre~e~ Add~e~ ' '- /Ci~p ~e Phone N~me a~d Address ~flL~ased Premises ' - A0oress - C~ip CoOe Na~'6f-O~anizati~n Leasing the P~emise~sse~) ' "' / L~ense Nu~er, ~ kno~ The la~ul ga~ling[a~ which the organ~ation will conduct is (check all that app,): ~ bingo ;~ raffles ~ Paddlewh~ls ~ pull-tabs ~ tipboards ~¢=~ ]~0~O= (See Rules 7861.0060, Subp 2D) Ciasa A and C premises pe~s: Ci~s B and D premiss permits: Rent tor bingo and ~11 other gambling actMties conducted Rent tor galling activ~ies not including bingo during that binoo ~casion may not exceed: is a m~imum of $1000 per month. $200 for U~lO 6~000 square toot; $300 tot up to 1~.000 square feet; and ~400 for more t~an 12.000 square feet. l~entlobeDaid'erbingo,casion~ $ [ Rent to be paid ~er month $ /~0, e:J Rent ~y not be ba'S~ on a percentage of ~eipts, profits from la~ul 9ambtin9, or on the numar of pa~icipants a~end~g a bingo occasion. An or~anaation ~yJnot pay rent to nseC.or to ~ny of ~s afl,hates for ~pace used ~or the co~duct o{ la~ul 9ambling. The area(s) leased ~hin the premises are // ' ~eet by ~ ' toot, tot a total o~ ~ ~ square teet feet by toot, for a total o~ squ~e teet. feet by tee~ tora total of squ~e feet. ']'ne Lease wdl go into~eflect at 12:01 a.m. on I / 19 ~ ,Y , and will end at 12:00 a.m. on y- .5 4 The bingo occasions ~ill be held (a maximum of 7 bingo occasions per organization): from (hours) ? (a.mJp.m.) to from (hours) (a.m./p.m.) to from (hours) ~ (a.m./p.m.) 1o trom (hours) (a.m./p.m.) to from (hours). ~ (a.m./p.m.) to (am/p.m-) on (days of week) (a.mJp.m.) on (days of week) (a.m/p.m.) on (days of week) (a.m./p.m.) on (days of week) (a.mJp.m.) on (days oi week) from (hours) (a.mJp.m.) to from (hours). ~ (a.mJp.m.) to (a. mJp.m.) on (days of week) (s. mJp.m.) on (days of week). 46