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<br />"in/ltesQ'. Lawful Gambling <br /> <br />LG220 Ap,pUcation for Exempt Permit <br /> <br />An exempt f)8tmit may me iss~ to II nonprafit Gfganization that: <br />- conducts lawful gambling en lve ar fewe.f days, aM <br />- aW8fcds .ss than '1O,{\}00 in prizes Guring a ealenc:lar year. <br /> <br />Page 1 of 2 9/08 <br />Fee is $5-0 for each eve,nt <br /> <br />for Board Use ()nfy <br /> <br /> <br /> <br />OrQanization name <br />Catholic Aid Association <br /> <br />Type of Donprofit erga:nizatiGR. Check one. <br />~ fratemat [OJ RetiQi0US [OJ Veterans [OJ Other l'lOOpfofit organization <br />Mailing adaress City State Zip Code <br />3499 Lexington Ave. N. Arden Hills MN 55126 <br /> <br />Previous gambling permit number <br /> <br />County <br /> <br />Ramsey <br /> <br />Na;me a1 ellief executive 0fficer (CEO) <br /> <br />Michael F. McGovern <br /> <br />Daytime phone number <br />651-490-0170 <br /> <br />Emait address <br />m mcgove rn@catholicaid.org <br /> <br /> <br />Do not attach a sales tax exempt status or federal 10 employer numbers as they are not proof of nonprofit status<o <br /> <br />I 0 I Nonprofit Articles of I"~~tion OR a eurre~ Cel1lfieate of Geed S1andil1fl. <br />Dontt ftlave a oopy1 nus certifiQate must be obtained each year from: <br />Secretary at State, Business Services Div., 180 State Office Building, St. Paul, MN 55155 Phone: 651-296-2803 <br /> <br /> <br />~ IRS Income tax exemptic;m [581{c)) letter In your organization'. name. <br />Don't have a copy? Te abtain a copy of your federal income tax exempt letter, have an organjzation offICer <br />contact the I;RS at 817-829-5500. <br /> <br />g <br /> <br />IRS - Affiliate of n.,tjonal, statewide, or International parent nonprofit organization (charter) <br />If your orga,nization faUs under a parent erganization, attach copies of ~of the following: <br />a. tRS letter snowing your parent organization is a nonprofit 601(c) organization with a group ruling, and <br />b. the charter ar letter from your parent arganization recognizing your organization as a subordinate. <br /> <br />I 0 I IRS - proof ,!revieuslr s~ to Gambling Control Board . .. <br />If you preViously SUbfTlifted proof of nonprofit status from the U~S, no attachment IS reqUired. <br /> <br />111;1,~tll-_;nll;IIIII"c!I.B;I~III!J-ltI._._.......: <br /> <br /> <br />. ..R_j.jiii'i;iiii';jij_ii\i;.';~'~ftW~;(f&~flje$.Ii$tthe$ite where the diaWingW.lfik~Pt~~) . <br /> <br />Catholic Aid Association (Home Ottic <br /> <br />Address (do not use PO box) <br />3499 Lexington Ave. N. <br /> <br />City <br />Arden Hills <br /> <br />Zip Code <br />55126 <br /> <br />County <br />Ramsey <br /> <br />Date(s) of activity (for ralles, indicate the date of the drawing) <br /> <br />?f -/f{..1tJol to I 0 - 30 - JtX:f1 <br />heck the box or boxes that indicate the type of gambling activity your Grganization will conduct: <br />o Bingo* ~ Raffles OPaddlewheels* OPull-Tabs* OTipboards* <br /> <br />* Gambling equipment for pull-tabs, bi~o paper, tipOOards, and <br />paddlewbeefs must I>e C!)f:)talfted from it distributor licensed by the <br />Gambting C0Atr0lloard. EXCEPTION: Binga hard cards and tHngo <br />number selection devices may be borrowed from anether 0f'ganization <br />authorized '0 conduct bingo. <br /> <br />To find a licensed- €listributor, go to www.gcb.state.mn..us and dick on Ust <br />of Ucensed Distributers, 0r caB 651-63-9-4076. <br /> <br />Also complete <br />Page 2 of this form. <br /> <br />