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hl]-17-20H 1I Fl-om-PARKVIEW CENTER SCHOOL <br />11.r7t�_r)esata kawful Gambling <br />1_..J220 Application for Exempt Permii <br />A :0MV <br />Type of nonprofit organization. Check Cne. <br />E] Fraternal L] Religious 0 Veterans <br />Mailing address <br />651 48T 43T9 T-764 P,a0a/GqS F-M <br />Fee Is $50 for <br />:each event <br />Pre <br />ge-IFn �iQ r)e7,N'f r7umt)c-r <br />ZOther nonprofjt'org�mlzafion <br />Internal Revenue servioe - IRS income tax exemption [501(c)] letter in yoUr organizotion's name. <br />Don't have copy? To obtain a copy Of YOUr federal income tax exempt l�ttff, send your federal 1C) nwrber and <br />Ulf date YOL11 organization In'[fially applied for ta)( exempt status 1 5 Lo <br />I1 P,O, Sox 2508, ROOM 4G1 0, Cfricifinatl, OH 46201 <br />VIInternal KeWnuo Service -Affiliate of national, state lido, or irternation@1 parent nonprofit organization charter`) <br />If your organization falls under a parent or anization attach copies of b= of the following <br />A <br />a, IRS letter showing your parent orqarizz;tlon is a registered nonprofli 501(c) organlzatfor vvllh a qr0UP rUlinq <br />b. the cl�armr or 4 Irom yotir parent orgaMzatlon reCognUing Your organization as a subordinate. <br />C.heck the box or W es that indicate the type Qf garribling activity your orgwiizatlon will condui;t, <br />ingo 2,Raffles El *Paddlt�wheels "Pull-Tabs 'K7pbo,,Ws <br />* <br />Gambling equiprncM for pull-tabs, tipboards, paddlewheels, and bingo (bingo pap(�r, <br />h rd cards, and birigo number 5election device) must be obtah d from a di5trfbutnr <br />licensed by the Gnmbling Controt Board, To find a 11censed distributcr, go to <br />wwvq.,qcb state .rwi-us 8Rd C-11Ck o7) List of Ucen5ed Di5tributons, Dr Cali 651-639-1076, <br />