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~r 06 05 03:22p ::: Minnesota Lawful Gambling L~215 Lease for Lawful Gambling Activity Narii~ of!e~~ owner Ofpref!\lses Businesslstreetaddress aw:--'" "l. City 763 784 9167 p.l /'0 11/04 Page 1 of2 . Slate The maximum rent aiowed may not exceed the limits established under Minnesota Statute 349.18, SUbd. l(b)(4). The limit as of May 1, 2004 is $1,750 in total per month for all organizations at tnis premises. The maximum rent allowed may not exceed the limits established under Minnesota StalJJte 349.18, Subd. 1(b)(4). . The limit as of May 1, 2004 is $2,500 in tolal per month for all organizations at this premises. Complete one option: Option A: 0 to 1oo,\, of thj9,l)'s proliits per month. Percentage to be paid % Complete one option: Option A: Oto20% of the gross profits per month. Percentage to be paid % Option B: When gross profits are $4,000 or less per month, $0 to Option B: When gross profits are $1,000 or less per month, $0 to $400 per month may be paid. Amoontto be paid $ $200 per month may be paid. Amount to be paid $ Option C: $D to $400 per month may be paid on theftrst $4,000 Option C: $0 to $200 per month may be paid on the ftost $1,000 ofgrossproftt Amount to be paid $ . PlusO%1D ofgrossproflts. Amount to be paid $ . Plus 0% to 10% of the gross: profib; may be paid per month on gross profits :20% of the gross proflts may be paid per month on gross profits over $4,000. Percentage to be paid % over $1,000. Percentage to be paid % <;hesJ< all activities thatwill be conducted: " -J,6'ull-tabs _Pull-tabs with dispenslng device ~ds ~wheel ~ with l>ible Rent Information: Bingo Noon Hour Bingo Occasions Rent may not exceed $25 per clay for noon hour bingo conducted between 11 a.m. and 2 p.m. at a premises with a license for the sale of intoxicating beverages on the premises. Rent to be "paid per bingo occasion $ ,...--------------, For any new bingo activity not previouslV " I induded in a Premises PermitApplic:atlon," I I attach a separate sheet of paper listing tho I days and hours that bingo will be conducted. L .J I1'this is an amended lease showing changes OCQJrring during the term of the current premises pennlt, both parties that Signed the lease must initial and date all changes. Changes must besubmitted b:l the Gambling Controllloard at least 10 days prior to the change. Write in the date that the changes will be e_e~~_" Lessor Date Organization Date Bingo and/or Bar Bingo Occasions Rent for bingo and all other gambling activities conducted dUring a bingo occasion may not exceed: . $200 per occasion for up to 6,000 square feet . $300 per occasion for up to 12,000 square feet . $400 per occasIon for more than 12,000 square feet . $25 per occasion for bar bingo conducted at any time In a bar (regardless of SQuare footage). Your organilation must oonduct another form of lawful gambling, and the premises must serve intoxicating liquor or 3.2 percent malt beverages. Rent to be paid per bingo occasion $ Amended Lease Only