Agenda - Council - 02/12/2013 - Laserfiche WebLink

Home

MINNESOTA LAWFUL GAMBLING LG220 Application for Exempt Permit An exempt permit may be issued to a nonprofit organization that: - conducts lawful gambling on five or fewer clays, and - awards less than $50,000 in prizes during a calendar year. If total prize value for the year will be $1,500 or less, contact the licensing specialist assigned to your county. ORGANIZATION INFORMATION Organization name Rum River Chapter of the Mn. Deer Hunters Association 12/12 Page ] of 2 Application fee (non refundable) tfLappiicatio posted t2r received: less than 30 days more than 30 days before the event before the event $100 $50 Previous gambling permit number X-30002 Minnesota tax ID number, if any Federal employer ID number (FEIN), if any 4326991 41-1390958 Type of nonprofit organization. Check one. Fraternal Religious Mailing address 1917 Rum River Drive NW Name of chief executive officer [CEO] Ronald Schleif Veterans City Isanti Other nonprofit organization State Zip code MN. 55040 County Isanti Daytime phone number E-mail address 763-753-3254 NONPROFIT STATUS Attach a copy of ONE of the following for proof of nonprofit status. Nonprofit Articles of Incorporation OR a current Certificate of Good Standing. Don't have a copy? This certificate must be obtained each year from: Secretary of State, Business Services Div., 60 Empire Drive, Suite 100, St. Paul, MN 55103 Phone: 651-296-2803 IRS income tax exemption [501(c)] letter in your organization's name. Don't have a copy? To obtain a copy of your federal income tax exempt letter, have an organization officer contact the IRS at 877-829-5500. _ IRS - Affiliate of national, statewide, or international parent nonprofit organization [charter] If your organization falls under a parent organization, attach copies of both of the following: a. IRS letter showing your parent organization is a nonprofit 501(c) organization with a group ruling, and b. the charter or letter from your parent organization recognizing your organization as a subordinate. GAMBLING PREMISES INFORMATION Name of premises where the gambling event will ge conducted. For raffles, list the site where the drawing will take place. Address [do not use PO box] City or township 753: Unlw'oov ` .7- I� Ar"'csfiq, s✓ Date[s] of activity. For raffles, indicate the date of the drawing. March 16, 2013 Check each type of gambling activity that your organization will conduct. Bingo* X Raffle Paddlewheels* Pull -tabs* Zip code Cod hty Anoka Tipboards* *Gambling equipment for bingo paper, paddlewheels, pull -tabs, and tipboards must be obtained from a distributor licensed by the Minnesota Gambling Control Board. EXCEPTION: Bingo hard cards and bingo number selection devices may be borrowed from another organization authorized to conduct bingo. To find a licensed distributor, go to www.gcb.state.mn.us and click on Distributors under the WHO'S WHO? LIST OF LICENSEES, or call 651-639-4000.