Laserfiche WebLink
<br />.. <br /> <br />~ <br /> <br />-~------~------- -- ~---- -------------------- - ------ ----- - -- - --~- -- - ---- <br /> <br />Page 1 of 2 4107 <br />For Board Use Only <br />Fee Paid <br />Check No. <br /> <br />Minnesota Lawful Gambling <br /> <br />LG220 Application for Exempt Permit <br /> <br />An exempt permit may be issued to a nonprofit organization Fee 50 <br />conducting lawful gambling activity on five or fewer days, and <br />awarding less than $50,000 in prizes durings a calendar year. for each event <br /> <br />ORGANIZATION INF()Ri\ftATIO.N <br /> <br /> <br />Previous lawful gambling exemption number <br /> <br />o Other nonprofit organization <br /> <br />~ <br />lJLJ <br /> <br /> <br />Check one of the following and attach a copy of your proof of nonprofit status. <br />NOTE: Sales tax exempt status or federal ID employer numbers are not proof of Income tax exempt status. <br /> <br />_1. NonprofltArtlcles of <br />Incorporation <br />OR <br />Certificate of Good Standing. <br /> <br />Attach a copy of your organization's <br />Nonprofit Mides of Incorporation <br />OR current Certificate of Good <br />Stanaing. <br /> <br />This certificate must be obtained <br />each year from: <br />Secretary of State <br />Business Services Div. <br />180 State Office Building <br />St. Paul, MN 55155 <br />Phone: 651-296-2803 <br /> <br />~ 2. Internal Revenue Service - national organization <br />~Check if proof previously submitted to Gambling Control Board. <br />OR <br /> <br />_Attach a copy of the IRS income tax exemption [501 (c)] letter in your <br />organization's name. To obtain a copy of your federal Income tax <br />exempt letter, send your federallD number and the date your <br />organization initially applied for tax exempt status to: <br />IRS <br />P.O. Box 2508, Room 4010 <br />Cincinnati, OH 45201 <br /> <br />_3. Internal Revenue Service - Affiliate of parent nonprofit <br />organization (charter) <br />_ Check if proof previously submitted to Gambling Control Board. <br />OR <br /> <br />_If your organization falls under a national organization, attach both <br />of the following: <br /> <br />a. a copy of the IRS letter showing that your national organization <br />has been a registered nonprofit 501{c) organization and carries <br />a group ruling, and <br />b. a copy of the charter, or letter from your national organization, <br />recognizing your organization as a subordinate. <br /> <br /> <br />. ,..' ,_..'---- .'- -. . -. .--.... - . -, . <br />G. :AMBLlN<3.'PREM'.ISESINFORMATIO.N.. . <br />~. _. ,_ ,_ >"".' ._.":".,,,___.4_''i~,''',.'''''''____'_:'_''_- - '.-. A' ..~.,=~>...I,-;- --. - ... <br /> <br />C~ <br /> <br />Check the box or boxes that indicate the type of gambling activity your organization will be conducting: <br /> <br />~ *Bingo [0" Raffles [EI *Paddlewheels tl2J *Pull-Tabs 10' *Tipboards <br /> <br />*Gambling equipment for pull-tabs, tlpboards, paddlewheels, and bingo (bingo paper, <br />hard cards, and bingo number selection device) must be obtained from a distributor <br />licensed by the Gambling Control Board. To find a licensed distributor, go to <br />www.gcb.state.mn.us and dick on Ust of UcensedDlstrlbutors. Or call 651-639-4000. <br /> <br />331) <br />