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=, APPLICATION FOR A LOCAL PERMIT OR CHARITY LOCAL PERMIT <br /> OFFICE OF ATTORNEY GENERAL <br /> SFN 9338(9-2009) <br /> Application for: ❑ Local Permit *p Charity Local Permit (one event per year) <br /> Name of Non-profit Organization Date(s)of Activity. <br /> eked <br /> Riding On Angels'Wings 4/11/201/3 4- to 4/11/20114 <br /> Person Responsible for the Gaming Operation and the Disbursement of Net Income Title Business Phone Number <br /> Vincent H. Babler Treasurer (701)866-8728 <br /> Business Address City State Zip Code <br /> 5062 120th Ave N Felton MN <br /> Mailing Address(if different) City State Zip Code <br /> Name of Site Where Game(s)will be Conducted Site Address <br /> Red River Valley Fairgrounds West Fargo, ND <br /> City State Zip Code County <br /> West Fargo ND 58078 Cass <br /> Check the Game(s)to be Conducted: *Poker,Twenty-one,and Paddlewheels may be Conducted only by a Charity Local Permit. <br /> o Bingo © Raffle ❑Calendar Raffle ❑Sports Pool ❑Poker* ❑Twenty-one* ❑ Paddlewheels* <br /> DESCRIPTION AND RETAIL VALUE OF PRIZES TO BE AWARDED <br /> Retail Value of Retail Value of <br /> Game Type Description of Prize Game Type Description of Prize <br /> Prize Prize <br /> Raffle Flat screen TV $600.00 <br /> Grill $150.00 <br /> Live Auction Small ATV $1,800.00 <br /> small items $2,000.00 <br /> 22 Rifle $300.00 <br /> Silent Auction Jewlery $800.00 <br /> (Limit$12,000 per year) <br /> Total: $ 5,550.00 <br /> Intended uses of gaming proceeds: handicapp bathroom, scholarships, horse care <br /> Does the organization presently have a state gaming license? © No ❑Yes - If"Yes,"the organization is not eligible for a local permit or charity local <br /> permit and should call the Office of Attorney General at 1-800-326-9240. <br /> Has the organization received a charity local permit from this or another city or county for the fiscal year July 1 through June 30? © No ❑Yes- If"Yes," <br /> the organization does not qualify for a local permit or charity local permit. <br /> Has the organization received a local permit from this or another city or county for the fiscal year July 1 through June 30? © No ❑ Yes - If"Yes," <br /> indicate the total value of all prizes previously awarded:$ . This amount is part of the total prize limit of$12,000 per year. <br /> Si nature of Organ' tive Qfficial Date Title Business Phone Number <br /> 2/11/2014 Executive Director (701)793-5153 <br />