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If the gamblling promises is within city limits- M, <br />a city official must check the action that the city is <br />taking on this application and sign the appilicat,ion. <br />Page 2 of 2, 1110 <br />If the gam blin&l premises is located In a township, a - <br />county official m ust check the action that the county, is taking <br />on this application and sign the apipli'caltlion. <br />A <br />owns dip officia,l is not required to sign the application. <br />Sig eceiiving application <br />UR <br />Date /I <br />(Optional) TOWNSHIP10. On, b�ehalf'olf'thie township, I <br />Tiltlle acknowledge that the organization is, apiply�i�ng for exempted gambling <br />Date c;vk activity Wthin township lli'mits. [A township has no statutory authority <br />to approve or deny, an application [Minnesota Statute 349., #1661)] <br />1 Print township name <br />Financial report and recoirdkeeping required <br />A financial report fbrm and instructions will be sent with <br />your permit, or use the online bill -in form a,vailablle at <br />wwwl.gcb. state. mn, us. Within days of the activity dI ate, <br />complete and return the finlanlcial report form to the <br />Gambling Control Board. <br />