Laserfiche WebLink
BANK RECORDS AUTHORIZATION <br />BY my, signature below, the Board i,s, hereby authorized to * <br />inspect the bank records of the <br />�General Ga,mbli,ng �Ba�nik Account whenever necessary to fulfill requirements of current gamblinS <br />rules ands law., <br />OATH <br />I hereby declare that <br />1. I hake read this applicatikon, and ail,l information subm-itted to the Board* <br />2 a All 'Information, submitted is t,runep accurate, and complete; <br />3* all other requireid information has been fully disclosed; <br />4* 1 am the ch�l,ief executive officer of the rg�anizatiolnl; <br />I a <br />510 1 assume full, responsibility for the fair and la,w�f'ull ope�r t,ion of all, activities to be <br />conducted; <br />61. 1 will familiarize myse�l,f with ' the laws of the State of Minnesota respecting gambling <br />and rules of the Board and agree , i,f licensed, , to, abide by those laws and rules, <br />including amendments thereto. <br />Official, Legal Namiel of Organization <br />HMME SOCT ETY O!P Rxm.sEy Colyw-7Ty <br />Title <br />ftelcutive Diretctor <br />'I'lectober 1198S <br />ACKNOWLEDGEMENT or NOTICE BY LOCAL GOVERNING BODY <br />I hereby ackniowledg�e receipt of a, colpy, of this application, By acknowledging receipt, I <br />admit, having been served with notice that this application will be reviewed by the <br />Charitable Gambling Control Board and If approved) by, the Board, will become effective 30 <br />days from the d1latie of receipt (n�oted below), unless a resolution of the local governing. <br />boldy is passied which specifically dli,sallows such activity and a copy of that resolution JLIS <br />received by the Charitable Gambling Control Board wi,thin, 30 days of the below noted date. <br />LOCAL GOVERNING BOD,Y <br />ORGANIZATION <br />Name of Representative for Gambling License Applicant <br />(serving notice) Joan Kosmalski <br />CC-00001�-01 (12/84) White - Board Canary - Board Pink - Applicant Goldenrod - Governing <br />(data entry) Body <br />