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14. <br />Li No J. Have Internal Contriols been submitted previously? If no, please attach copy. <br />Applicant (Official, Ilegal name of organization) <br />oe <br />iAjjaHdT.V <br />6. City, State, Zip,... <br />NFM%i <br />5. Business Address of Organization <br />11 <br />A 10% <br />?am Me I <br />"I bi. Number of active members 16. Number of years in existence <br />drM6- <br />oso'o 71�z <br />17 -, Name of Chief Executive Officer <br />.NPPM% L-0 <br />C."Y n 4, Aj P r% i4i r <br />Business Phone Number <br />( IG I, )i (q, cop C? o 3pr <br />19. Name of establishment wihere gambling will bii <br />conducteld <br />L M <br />21, 1. City, State, , Zip <br />TM7> IM - <br />I �6 U, 9 6V I L Or <br />4 <br />Note; If less than four years,, attach <br />evidence of three years <br />existence. <br />18. Name of treasurer or person who accounts for other revenue - s, <br />of the organization. <br />Title <br />T"'REASuIt.EfZ <br />Business Phone Number <br />20,- Street address (not P.O. Box Number, <br />/U <br />22. Count where gambling premises is located) <br />Canary-Applicant <br />Pilnk-Locail Governing Body <br />