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Minnesota Lawful Gambling
<br />LG215 Lease for Lawful Gambling Activity
<br />
<br /> Name a¢;es'~cr ~ ' 8usiness~stt~et ~dress
<br /> I[ same as legal owner, write :.n "SgME") ·
<br />
<br /> 11/04
<br />Page 1 of' 2
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<br />S~2te
<br />
<br />Z~p
<br />
<br /> Da~me phcne
<br />70' - 2£ / q
<br /> Da)*Jme phcne'
<br />
<br /> Name of leased premises ,Street addre~ :C.~ Z!p ' Daytime phone
<br />
<br /> N~me~f tessee (organizatia~ ~easing the premises) : ;0rganizatian ~i~nse number Da~ me phone
<br />
<br /> Rent I~for~ation
<br /> (for actlvit/ invclving puli-tabs, ~pbcards, p~ddlawheeW, and pu{l-tab dispensing devices. No le~se required for m~es.)
<br /> Booth operation - sales of Gambling e;ui~ment by a~ employee {or : Bar operation - sales of Gambling eGui~ment ,~in a leased
<br /> volunteer) cf a ~icecs~ organization within a ~arate e~dcsure:~a} is : ~remi~s by an employee cf ~qe ',e~r ~cm ~ common area where
<br /> dis~n~ from areas where fccd and ~everages are seld~ , - .fccd and ~evera~es are a[~
<br /> Does your organization O~ a~th~r~organiza~o~ condu~ gamblin~ -
<br /> from a booth o~raUon at ~i~ Io~l~on? ~Yes No
<br />I~ y~u ~ver~d yes ~o ~he que~on above~ mn~ fi~i~ a~e ~ ff~ybu an~ered ~0 ~o ~e que~on ~b~ve~ ren~ I~mi~ are
<br />
<br /> bas&,d on Be following ccmbinat~cns of ope~t~on:
<br />- 8ar operation .
<br />'- ~aroperation with ~ull-tab di~en$ng device
<br />- Pull-tab dispensing de,,ice onF/
<br />
<br /> The maximum rent ~"
<br /> ,, .c;',e, racy not exceed the }imits
<br /> e~ablished under Ninnesota Statute 349.18, Subd. l(b)(4).
<br /> T'ne limit as of Hay !, 2004.is 52,500 in total per month
<br /> .for all organizafdons at this premises.
<br />
<br />Complete one option:
<br />!OPtion A: 0 to 20% of the gross profits per month.
<br />Percentage to be paid %
<br />
<br />OPUon B: When gross profits are 51,000 or less per month., $0 to
<br />.$200 per month may be ;aid. Amcunt to be paid
<br />
<br />Option C: $0 to 5200 per mcn~q
<br /> m~'/~ paid on the fir~ 51,000
<br />ofgi'oss profits. Amount to be paid $ .Pius 0% to
<br />:20% of the gross profits ma'/be paid per month on gross profits
<br />eve{' $!,000. Percentage to be paid __%
<br />
<br />Paddlewheei with table
<br />
<br />based on the follo~4ng combinaUons of operation:
<br />- Bcoth ope~Jcn
<br /> Sooth operation and pull-tab dispensing device
<br /> Booth opera,on and bar operation
<br /> Sooth operet,on, bar operation, and pull-tab disPens,ng device
<br />
<br /> %qe maximum rent al:owed may not exce~ the ,imi,.~
<br /> established under Hinnesota Statute 349.18, SObd. l(b)(4).
<br /> 'Fne limit as of Flay 1, 2004 is 51,750 in total per month
<br /> for all organizations at this premises.
<br />
<br />Complete one option:
<br />Option A: 0 to 10% of the,gross profits per month.
<br />Percentage to be paid /('.) %
<br />
<br />Option B: When gross profits are $4,000 or less per month, $0 to
<br />$4c0 per mcnth ma,/be paid. Amount to be paid 5 . ·
<br />
<br />Option C: $0 ~o ~400 per month may be paid on the fi, =ret .$4,000:
<br />of Gross prcEt. Amount to be paid $ ; Plus 0%
<br />10% of the gross profits may be paid per month on gross profibs
<br />over $4,000. Percentage to be paid ~%
<br />
<br /> C.,I)eck all activities thatwill be conducted:
<br />._)LPull-tabs Pull-tabs with dispensing device .'ripbOards i~Paddlewheel
<br />
<br /> Rent InformatiOn: Bingo
<br />Bingo and/or Bar Bingo Occasions
<br />Rent for bingo and all other gambling activities
<br />conducted dur!ng a bingo cccasion may not e.xceed: · $200 per cccasion for up to 6,000 square.feet
<br /> ° $300 per cc:asien for up to t2,000 square feel;'
<br /> · 5400 per occasion for more than 12,000 square feet
<br /> · $25 per cccasicn for bar bingo conduced at any time in a
<br /> bar (regardless of square footage). Your organizatio0
<br /> must condu~ another form or' lawful gambling, and the
<br /> premises must ser/e intoxicating liquor o¢3.2 percent
<br /> malt beverages.
<br />Rent to be paid per bingo occasion 5
<br />
<br /> Noon Hour Bingo Occasions
<br /> Rent may not exceed 525 per day for noon hour
<br /> bingo conduced beb¢veen ~1 a.m. and 2 p.m. at a
<br /> premises with a license for the sale cf int0xicadng
<br /> beverages on the premises.
<br />
<br />~ Rent to be paid per bingo occasion $
<br />r' For any new bingo activity not previously -~
<br />I included in a Premises PerrnitApplication, ]
<br /> I attach a separate sheet of paper listing the j
<br /> days and hours that bingo will be conducted.
<br /> L- !
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<br />If t~s is an amended lease showing ~ar. ges oCCUi'ring ddnhg t~e term of bhe current premises permit, bcbh paddes
<br />mat signed the Iease, must i,nitial and date all changeS.. . Cha~geSr mu% be submi~ed, to ~e Gambli~. ._. 5onb'ct Board
<br />at least 1 o d,,~3Cs prt,,r~61:he change. Write irl the datethat the changes w:ll be often*dye '= :' "' :' -
<br /> Date.'' ~ ' organization Date
<br />L essa; ~- ~-~' .'-'.-~ '.".~.." : ..... "
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<br />Amended
<br />Lease
<br />Only
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