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Minnesoita Charitable arm tin , Control Board <br />2 <br />GAMBLING LICENSE APPLICATION <br />(:lass A, B, o r C) <br />GAMBLING SITE AUTHORIZATION <br />By my a i gna tu re be I o-q 9, local 1 saw en f'o rcement Officer's 1 or agient,.,, of the Board are hereby <br />aut,ho ri zed to enter ipon the s --te sit any time gambling 1, 5 beillig conducted to observe <br />the gambling and to enforce the law, for any unauthorized game 1-r precticep, <br />BANK RECORDS AUTHORIZATION <br />By my signature below, the Board is hiereti) authorized to inspect the bank records of the <br />General, Gambling Bank Acclount, wheriiever necessary to fulfill requirelments of current gambling <br />rulles aind' law, <br />A 0 A, TH <br />1 hereby declare that <br />I. 1, haivie read Viis application and all, Information submitted to the Board; <br />Z9 All information submitted Is true, accurate, and complete <br />3w <br />ell other required information has been fully disclosed; <br />4 W, I am the chief executive officer of the orgainization, <br />5, 1 assume full, responsibility for the fair and lawful operation of all activities to 'be <br />c o n du c t, le, d ; <br />6 I will familiarize myse 1f with the la�ws, of thie State of M' inniesota respecting gambling <br />and rules of the Board and agree, if licensed, to abide by those laws and rules, <br />including amendlmenits, thereto* <br />ACKNOULEDUMENT OF NOTICE SY LOCAL COVERNINGI BODY <br />M-000011-01 (112/84)1 <br />