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MINNESQTA LAWFUL GAMBLING LG220 Application for Exempt Permit 4/23 Page 1 of 3 An exempt permit may be issued to a nonprofit Application Fee (non-refundable) on five or fewer days, and organization that: . conducts lawful gambling Applications are processed in the order received. If the application awards less than $5 Ming in prizes during d calendar is postmarked or received 30 days or more before the event, the year• application fee is $IOO; otherwise the fee is f I50. If total raffle prize value for the calendar year will be Due to the high volume of exempt applications, payment of $1,500 or less, contact the Licensing Specialist assigned to additional fees prior to 30 days before your event will not expedite Your county by calling 651-539-1900. service, nor are telephone requests for expedited service accepted. ORGANIZATIO "!N FOR ATI(3N i Organization Previous Gambling Name: Minnesota Buildin and Construction Trades Council Permit Number: X- 93220-18-004 Minnesota Tax ID Federal Employer ID Number, if any' 8565494 Number (FEIN), if any: 41-087069 Mailing Address: 353 West 7th Street Suite 105 City: St. Paul State: MN Zip: 55102 County: Ramsey Name of Chief Executive Officer (CEO): Tom Dicklich CEO Daytime Phone: 651-287-9999 CEO Email: tdicklich@mntrades.org (permit will be emailed to this email address unless otherwise indicated below) Email permit to (if other than the CEO): kevin snow lobe r.com NONPROFIT STATUS Type of Nonprofit Organization (check one): EDf`ratemal 0 Religious Veterans Other Nonprofit Organization Attach a copy of one of the: following showing proof of nonprofit status: (DO NOT attach a sales tax exempt status or federal employer ID number, as they are not proof of nonprofit status.) ❑ A current calendar year Certificate of Good standing Don't have a copy? Obtain this certificate from: MN Secretary of State, Business Services Division Secretary of State website, phone numbers: 60 Empire Drive, Suite 100 www.sos.state_mn.us St_ Paul, MN 55103 651-296-2803, or toll free 1-877-551-6767 ❑ IRS income tax exemption (50I(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 toll free at 1-877-829-5500. 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: 1. IRS letter showing your parent organization is a nonprofit 501(c) organization with a group ruling; and 2. the charter or fetter from your parent organization recognizing your organization as a subordinate. GAMBLING PREMISES INFORMATION i Name of premises where the gambling event will be conducted (for raffles, list the site where the drawing will take place):. 34th Red Bull „Infantry Division Headquarters Physical Address (do not use P_0. box): 4$LM_HamHne AVE N Check one: M City: Ard,-n Hjjjs _ _-- Zip: 55112„ County: Township: Zip: County: Date(s) of activity (for raffles, indicate the date of the drawing): - Check each type of gambling activity that your organization will conduct: Bingo Paddlewheels =Pull -Tabs =Tipboards (-Rafe Gambling equipment for bingo paper, bingo boards, raffle boards, paddlewheels, pull -tabs, and tipboards must be obtained from a distributor licensed by the Minnesota Gambling Control Board. EXCEPTION: Bingo hard cards and bingo ball selection devices may be borrowed from another organization authorized to conduct bingo. To find a licensed distributor, go to rvrvw,mn.gov/gcb and click on Distributors under the List of Licensees tab, or call 651-539-1900.