My WebLink
|
Help
|
About
|
Sign Out
Home
1993_1011_packet
Roseville
>
City Council
>
City Council Meeting Packets
>
1993
>
1993_1011_packet
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
10/13/2011 10:17:47 AM
Creation date
10/13/2011 10:02:47 AM
Metadata
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
126
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
LG316 Minnesota awful Gam lin g <br /> Bingo H Personnel Affidav't <br /> STATE OF f &4 AFFIDAVIT OF QUALIFICATION <br /> . . FOR BINGO HALL LICENSE <br /> COUNTY of AND CONSENT STATEMENT <br /> (Pursuant to Minnesota Statute 349.1 <br /> �P ) <br /> -�+ .■ � Z0.071 u nd r oath state that:(type or print) • <br /> I have not been convicted of a felony. <br /> 2. 1 have never been conv'Icted of a crime involving gambling. <br /> 3. I& *)t owe delinquent taxes in excess of 500 as defined in Minnesota Statute section 270.7 t <br /> 4. 1 am not a licensed distributor or aff iliate of a distributor under section 349.161. <br /> 5. l am not a licensed manufacturer or affiliate of a manufacturer under section 349.163. <br /> 6. 1 am not a wholesale distributor of alcoholic beverages. <br /> 7. 1 will not provide any stafi to conduct or assist in the conduct of any lawful gambling on the premises. <br /> 8, 1 will not acquire, provide storage control or inventory control, or report the use of any gambling equipment <br /> used by an organization that conducts lawf u gambling on the prernmes, <br /> g. 1 will not provide accounting services to any organization conducting lawful gambling on the premises. <br /> 10■ 1 will not so-:Y;i,suggest, encourage or make any expenditures of gross receipts from lawful gambling of <br /> an organization. <br /> 11. l will not charge a fee to a person without which the person,could not play a bingo game or participate in <br /> another form of lawful gambling on the premises. <br /> 12. i will not provide assistance or parti ;pate in the conduct of lawful gambling on the 'premises. <br /> 13. l will not prepare bingo packets. <br /> In addition, I understand, agree and hereby irrevocably consent that s u'As and actions relating to the subject matter of <br /> the attached bingo hall license application, or acts or omissions arising from such application, may be commenced I <br /> against me in a6y court of competent jurisdiction in Minnesota by service on the Minnesota Secretary of State of any <br /> sum mo ns,process or pleading authorize d by the lags of M i nngWa■ . <br /> By signature of this document, the undersigned authorizes the Department of Public Safety_jo conduct a background <br /> cheer or review and to share the results with the Lawful Gambling Control Board. <br /> k <br /> _Failure to provide req u i,ed information or providing false or misleading information may r e'su It in the den[al or revo6$tion <br /> of the license. t <br /> ~ u <br /> FURTHER AFFIA T SAYETH NOT, excapt that this Affidavit and Consent Statement are submitted in support of the. <br /> application for bingo hall license application from the Lawf u 1 Gambling trol Board. <br /> l* r ' . 4 <br /> ub�scribe�' 1946 Y his (Signature of a Pp lica - in o Hall Personnel <br /> Y n K i <br /> J?�d ayof A C4 qv <br /> toe: <br /> Name of B., ,: Hall <br /> r <br /> Notary Public Bingo Hall License Nuimber <br /> My commission expires : . <br />
The URL can be used to link to this page
Your browser does not support the video tag.