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nesoit 'a' Charitable Gambling Control Board <br />T <br />GAMBLING LICENSE APPLICATION <br />(Class A, B. or C) <br />GA"BLING SITE AUTHORIZATION <br />By my signature below, local law enforcement officers or agents of the Board are hereby <br />authorized too enter upon the site, at any time, gambling is being conducted, to observe <br />the gambling and to enforce the, law, for any unauthorized, game or practice,. <br />BANK RECORDS AUTHORIZATION <br />By my signature ble,low, the Board is hereby authorized to inspect the bank records of the <br />General Gainblinig (Bank Account whenever necessary to fulfill requirements of current gambling <br />rules and' law. <br />[I <br />I hereby declare that <br />10 1 have read this application and sill Information submit,teld to the Board; <br />2. All Information submitted is truieg accurate,, and complete; <br />3 all other required information has been fully disclosed; <br />4, 1 am the chief executive officer of the organizat-ion - <br />, <br />5,w 1 assume full responsibility for the fair and lawful olperiation of all activities to be <br />conducted; <br />6, 1 will familiarize imysel,f wlith thei laws of the State of Minnesota respecting gambling <br />and rules of the Board and agree, if licensed, to abide b,y those laws and rules, <br />including amenidmilen�ts thereto. <br />Official, Legal Name of Organization <br />.()rl ' luis Cbristi C-hUrCb <br />Signatuircoe-Wusk be signed by Chi Executive Officer) <br />Title <br />172 � -PM , <br />ACKNOWLEDGEMENT OF NOTICE BY' LOCAL GOVERNING BODY <br />