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LffAllr I f3V <br />pas 19, <br />PRINTED.-07/02197 <br />........... - — - - — — - - -- --------------- <br />LICENSE NUMBER: B,H02,6 NAME OFAPPLICANT: Knights of Clolum,bus <br />11 <br />LIG,302, Bingo Hall Occas*on List; <br />LG3 1,51, Bingo H�all Personnel Information <br />i-ma! Uni"t of Government, resolution of approval;, and <br />,siLicense Renewal application fee of $2,500. Make, Checks payabile to "'State of Minnesota <br />(Fees are considered eamed and are not priolrated or triansferla,ble.) <br />Ni <br />Maxil application and a,ttachmen,tsil to: <br />Gambling C�on,troll, Board, <br />Suite 300 S <br />County Road B <br />Roseville, MN' 55113 <br />Allow eight weeks for application, processing <br />This Publication will, he made available M' alternative format (i.e., large print, Braille) upon, request. <br />Hearing lnplaired individuals us*M'g a TTY may call the Minnesota Relay Service at 1-800-6127-3529. <br />The hiformation, requested, on this form, (includi any attachments) will be used by the Gambli Control Board (GCB) to determine your <br />Ing M9 <br />qualifications to, be mi'volved in, lawful gambil,m"'g activities M" Minnesota,, and to assist, the GCB in conducting a, background investigation of you. <br />You have the right to refuse to supiply the information requestedl -I however, if you re se to supply thus information, the GCB may not be able to <br />determine your qualifications and, as a consequence,, may refuse to issue you a, license. If you supply the information rqquested, the GCB will <br />be able to process your application., <br />