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Minnesota Charitable Gambling Control Board 4' <br />GAMBLING LICENSE APPLICATION <br />(Class A, B, or C.) <br />GAMBLING SITE AUTHORIZATION <br />By my siglniature below, local law enforcement officers or agents of the Board are hereby <br />authorized to enter iupoin the site,, at any time glaimb,ling is being conducted, to observe <br />the gambili,ng and to enforce the Law for any unaluthiorized game or practice, <br />GANK RECORDS, AUTHORIZATION <br />S I <br />By my signature below, the )Board oard is hereby authorized to inspect the bqnk records of the i <br />General Gambling Bank Aiccoun�t, whenever necessary to fulfill requirements of current gambling <br />,rules and law. <br />1L W, <br />I hereby declare that <br />1 - I have read this application and all information, submit,ted to the Board; <br />2,61 All information submitted is true, accurate, and complete; <br />3. all other required information has been fully disclosed; <br />4. 1 am the chief executive officer of the organization; <br />5, 1 assume full, responsibillity for the fair and lawful operation of all activities to be <br />ic o n d u c t, ie d" ; <br />60, 1 wlill, familiarize myself with the laws of the State of Minnesota respecting gambling <br />and rules of the Board and agree, if licensed, to abide by those laws and rules, <br />incliuding amenidments, thereto. <br />ACKNOWL EDGE IVAT OF NOTICE BY LO C A,L GOVERNING O0Y1 <br />CC-0iOi001-01, (12/84) White Board <br />