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Minnesota Lawful Crainibling Gambling License Application, - Part iix X.Y." Oath yeti I he reby co n s,e, nt th at local law enflorceim a nt off ice rs, the board br, ag is nts of the board, or th e cam miss ione r of rave n u e or public, safletyli or agents at the colm mission er's�,, may enter the, Promises to enforice the law. B M1 Records Authorizadon Thi a board is authonz ed to, in s pect the bank records of th e g ambli ng aiccou nit, wheneve r niecessary to f u lf III rei u ireim ents of I current gambling rulles and law. I declare, that: all have read this application and all 'Information submitted to the boa,rdi-, @A11 information is true,,, accurate And complete; *All othe,ir required li,nf ormation has been fully disclosed, *I am the chief executive officer of' the organization; &I assume full responsibility for the, fair and lawful operation of all activities to be conducted; &I will familiarize myself withl the, iaws, of Minnesiota governing lawful gamblingi and rules of the board and agree if licensed, to abide by those laws andrules, including amendments, to them; &A membership list of the organization zationi will be available within seven days after it is requested by the board; •Any changes in application information will be subm teed to the Ibolard and local government within 10 days of the change; and *A termination plan will be submitted to lhbibcard within 15 days whim the organization's license is terminated. Signa, �re oi of executive off �ic ri Date Local Goi-Vemment Acknowledgement .. ....... The city Ali musit signi # the gam Dfing premisies jisi located withib any city firnits. nF county, "ANDi township" must s*n if the gambfing premisiesi is, locatied4fthin a township. 19i I have receivied ai copy of this application. This application will be reviewed by the Gambling Control Division, and it approved by the Director, and will become effective 610i days from the date of receipt by thei city or county, unless the local government i (city or counity) passies a resolution to s,plelcff ically forbid the activity. A, copy of that resolution must be received by the Gambling Control Division within 60 days of tihei date filled in below. city or countym* Refer to the Instructions, for the required attachmeints. Mail to: Department of Gaming Gambling Control Divisilor Mail Station 3315 St. �Pau�l, MN 5513146-3315 Township"(Coni ifli adddion to county signature) Townsimip name Signature cat person recelimnig apple ton Is townshipo 0 organized 0 unorganized 0 unincorporated