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FOR HOARID USE ONLY <br />LG200A Minnesota Law.&I Gambling <br />Rev. (914/90) <br />Org ation License Application - Part 1 <br />lle6 <br />Number of Acdve Members 9"' (rnust be ag�e IS and older) <br />Men, &)as to organization hold, regutu meelfingsi? Day(si) 2nd Tue s Hours rT - I M <br />-day I <br />� theompensation Schedule for ft current year been subaed on form provided by the board? -0 yes 0 If no, VIach a c*py <br />Have InternaJI Controls r the, current year been submilled an Me rovikied by, to, board? M yes E3 If no. attach a copy* <br />D F. - =r I a .7 . Mer.14F74-117-71 <br />4 - a VO -� M <br />C3 Class A, — Bingo, Raff lea, Pladdliewhise�ls, Tipboards, Pull-tabs. <br />r ,gin, Class B — Raffles, Paddlewheels, 11pboards, Pull-tabs <br />Class C — Bingo only <br />Class D — R,affl�es, only <br />�Zj <br />St kt!M4�' L-1 c. hecic, <br />0 Organization h�M, never been ficensed. <br />:U Renewal of existing ficense — Fill in cgM011ele liceinse number B–CO113m-001 <br />1, icenise —1 Fill, in comptelte ficenso �number <br />C:1 Change in da2s of existing li <br />Previdusly expired licianso —1 �Fill in cornateii licensie number <br />i <br />