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1992_0127_packet
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1992_0127_packet
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10/31/2011 3:11:06 PM
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win number MmI of kensel kwimle in ft *dm= of Om I* box, to liconse chm #W de bee 0* types of <br />1B I 9mbling your, wgiadmi n will be caridli ng�: <br />34� <br />RW.001.101 Clus. A - Pullillill, tipboards, - 111 9wheels, mows wgo A.Mm ro • Bingo o* <br />Orgenintion The A,mrican Legion Bum" ID Number (MN S" A Use Tax Permit) <br />bw, - cri,&2, PC st 5142 .0, <br />111ole-petown, Nbn �10 <br />Busiriorps, Address, of Orgian�indon, - Street or P. 0 Box (Do not use address, *if gambling nwu_cw) <br />70�O 'Wea.,+.. Cc Rd C <br />C* State Zip Co:W County Dayfte phone number <br />RI o se v 11, le c.1 -1 qvI r I <br />5 ol 16 L Ramse -A. <br />FuN name, I chief axamfive <br />Lut Narnel First, Namie Akde Name, Widen T"Itle, raf <br />Mo Bile a Jalm 8 Jroh n Comr-ider, <br />Address of "t --- wi1w otfrow So" or P. 0. Box <br />28,36 Hurion <br />State Zip Code, County <br />5 R a rn,* ev <br />R o sevi.2 l,e 51 a&. 13 <br />EU11 D�ame of cmanization's ftensurer, <br />Uu�t IName first Name Wide Nme Makien Tide Date of birth 1 Daytime phone number <br />h I John .ance 01'r <br />S "TZ Ch F, r 1 .,.e ea p ir A <br />Number of Active Members (m�u�st be age 18 and older), Vftn does ft organization hold regular meli? <br />Day, of ~k Pnrl "';jg 2 F <br />LEM <br />re of Ch eculfive Off , icer <br />4 <br />Mail with required attivichmenu too <br />Gambling Colftoll Board <br />Rosellwood Plaza South, 3rd Floor <br />171111 W., County Road 8, <br />%sevillie, MN S51 13 <br />41-1 1 C <br />
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