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-Minnesota Lawful Gambling <br />Gambling, License Application -w Part 3 <br />Oiatn <br />g site orization <br />I hereby consent that local law enforcement officers, the board or agents of the board, or the commissioner of revenue or <br />M <br />public safety, or agents of the commissioners, may, enter the, promises to enforce the law. W� i W;-6. <br />B, Records Authorization I <br />'The board is a,uthlorizied to inspect the and records of the game ling account whenever necessary to fulfill requirennents of <br />current, giamlblling rules, and llaw. <br />I declare that: <br />all have r.90 this application and all information submitted to, the board); <br />*All information is true, accurate and complete; <br />*All other required information has been fully, disclosed; <br />*I arn the chief executive officer of' the organization; <br />,011 assume full responsibility, for the fair and lawful operation of all activities to be conducted-, <br />*11 will fa,miliadze myself with the laws of Minnesota governing lawwf ull gambling and rules of the and and agree, if licensed, to <br />abide, by those laws and rules,,, Including arnendmentis to there; <br />,*A membership list of the organization will be available within seven days after it is requested by the board; <br />•Any changes in application information wiill be s'ub mitted to the board and local government within 10 days of the change; and <br />ji termination plan will be submitted to the board within 15 days when the organization's license is terminated. <br />7 <br />All <br />dIW OP 0 <br />A A A A <br />IP <br />Refer to the Instructions for the reqluired attachments. <br />Mail to: Department of Gaming <br />Giambling, Controi Division <br />Mail Station 3315 *-, <br />St. P au f NN 55146-33�15 <br />Township" (compime inawhicin 10 Couffly svinaum) <br />Township name <br />%L <br />;t- <br />Ir <br />Silignature, oil person receMnig applicMn <br />4.0 <br />T, Uwe recel"M3 <br />Is township 4s., 1:1 organized 0 unorganized 0 unincorporated <br />iii <br />, It <br />SIMM <br />