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<br />ACKNOWLEDGMENT
<br />GAMBLING PREMISES AUTHORIZATION
<br />I_BY GIVE CONSENT TO LOCAL LA. W ENFORCEMENT OFFICERS, THE GAMBLING CONTROL BOARD, OR AGENTS
<br />o BOARD, OR THE COMMISSIONER OF REVENUE OR PUBLIC SAFETY, OR AGENTS OF THE COMMISSIONERS,
<br />TO ENTER THE PREMISES TO ENFORCE THE LAW;
<br />
<br />BANK RECORDS INFORMATION
<br />THE GAMBLING CONTROL BOARD IS AUTHORIZED TO INSPECT THE BANK RECORDS OF THE GAMBLING ACCOUNT
<br />NHENEVER NECESSARY TO FULFILL REQUIREMENTS OF CURRENT GAMBLING RULES AND STATUTES,
<br />
<br />I DECLARE THAT:
<br />I HAVE READ THIS APPLICATION AND ALL INFORMATION SUBMITTED TO THE GAMBLING CONTROL BOARD;
<br />ALL INFORMATION IS TRUE, ACCURATE &~ COMPLETE;;
<br />ALL OTHER REQUIRED INFORMATION HAS BEEN FULLY DISCLOSED;
<br />I AM THE CHIEF EXECUTIVE OFFICER OF THE ORGANIZATION;
<br />I ASSUME FULL RESPONSIBILITY FOR THE FAIR AND LAWFUL OPERATION OF ALL GAMBLING
<br />ACTIVITIES TO BE CONDUCTED;
<br />I WILL FAMILIARIZE MYSELF WITH THE LAWS OF MINNESOTA GOVERNING LAWFUL GAMBLING AND RULES
<br />OF THE G~IBLING CONTROL BOARD AND AGREE, IF ISSUED A PREMISES PERMIT, TO ABIDE THOSE LAWS
<br />AND RULES, INCLUDING AMENDMENTS TO THEM;
<br />ANY CHANGES IN APPLICATION INFORMATION WILL BE SUBMITTED TO THE GAMBLING CONTROL BOARD AND
<br />LOCAL UNIT OF GOVERNMENT WITHIN TEN DAYS OF THE CHANGE;
<br />I UNDERSTAND THAT FAILURE TO PROVIDE REQUIRED INFORMATION OR PROVIDING FALSE OR MISLEADING
<br />INFORMATION MAY RESULT IN THE DENIAL OR REVOCATION OF THE PREMISES PERMIT.
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<br />SIGNATURE OF CHIEF EXECUTIVE OFFICER DATE
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<br />L GOVERNMENT ACKNOWLEDGMENT . '. . ., ,.' ',.. ,',-,.. . .
<br />1, E CITY' MUST SIGN THIS APPLICATION IF THE GAMBLING PREMISES" IS LOCATED WITHIN CITY
<br />LIMITS,
<br />2, THE COUNTY" AND ,TOWNSHIP'" MUST,. SIGN THIS APPLICATION IF SHE GAMBLING ,PREMISES .-IS .
<br />LOCATED ,WITH'IN'A'TOWNimIP':' <",',:";' -""'''-; '.' '-'",;-i"';'):'7r.:.L>. ,--,' ,'.. '."', --<.'
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<br />3, FOR TOWNSHIPS THAT ARE UNORGANIZED OR UNINCORPORATED, THE COUNTY" IS REQUIRED TO ,ATTACH
<br />A LETTER TO THIS APPLICATION' INDICATING' THE' TOwNSHIPS' STATUS ,:.', ';,;,e,',,'':' ',;.,," .
<br />. ".
<br />4, THE LOCAL UNIT OFi30VERNMENT (CITY OR COUNTY) MUST PASS A RESOLUTION SPECIFICALLY: . ',. . " .
<br />APPROVING 6R DENYING THIS APPLICAT'ION.'" '. , .r.:;~,--;d;:l'
<br />5. A COPY OF THE LOCAL UNIT OF 'GOVERNMENT 'SRESOLUTION APPROVING' .'THIS'APPLICATION' MUST BE
<br />"ATTACHED TO THIS 'APPLICATION.' ).'0'.1,:,,:. . .'" ""<'V~.::\{....(<\.:"",, ""(' .... ';'<','..,/>,,,'
<br />6 . IF THIS APPLICATION IS DENIED By,THE LOCAL UNIT OF.. GOVERNMENT ,IT SHOULD NOT BE. SUBMITTED
<br />TOWN~~I~~E GAMBLINGCONTR~L BOARD :;::;,~> . ,', . >;i.'?~.~/>"i',',:;," ''',; . ,,>,.; ", '.'.. ~,
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<br />BY SIGNATURE BELOW, THE TOWNSHIP ACKNOWLEDGES THAT THE ORGANIZATION IS APPLYING FOR'A"
<br />PREMISES PERMIT WITHIN TOWNSHIp.LIMITS, .."
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<br />CITY' OR COUNTY" ." __ TOWNSHIp..'. ,:, . , '
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<br />CITY OR COUNT"X :~,) l' .... .,' , ,.." ,I TOwNS,~IP ,N~E.;->;"';' . ..,:':;;" "
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<br />APPLICATION.. .. .I'SIGNATURE'OF. PERSON RECEIVING'APPLICATION'
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