e. Permits for raffles - Laserfiche WebLink

APPLICATION FOR A LOCAL PERMIT OR CHARITY LOCAL PERMIT OFFICE OF ATTORNEY GENERAL SFN 9338 (07-2003) Application for: rn Local Permit * 0 Charity Local Permit (one event per year) Name of Non-profit Organization Date(s) of Activity Close Up /lJù vtm,be ( ;?3, ~ODI.I to M,ue,rv¡,Þev .:131 ::¿ool{ Person Responsible for the Gaming Operation, Including Disbursement of Net Income Title Business Phone Number Bruce Schéie Advisor 428-3177 Business Address City State ZiS ~ode 55 1st Ave S Kindred ND 051 Mailing Address (if different) City State Zip Code Name of Site Where Game(s) will be Conducted Site Address Kindred School 55 1st Avp S~ City State I Zip Code County Kindred ND 58051 CaBS Check the Game(s) to be Conducted: . Poker, Twenty-one, and Paddlewheels may be Conducted only by a Charity Local Permit. DaBingo IKI Raffle DCalendar Raffle DSports Pool DPoker' 0 Twenty-one' 0 Paddlewheels' DESCRIPTION AND RETAIL VALUE OF PRIZES TO BE AWARDED Game Type Description of Prize Retail Value of Prize $ .J.), ~"'- ()() S~ -C) 0 Game Type Description of Prize Retail Value of Prize $ (Linit S12.000 per year) Total: $ 600, ôÒ Intended uses OfgamlngprOCeeds:~O.N -ryo.j (7 - ftoce.A./~ 90 'To ~ 7v ill'll T~I ìJr {/ Does the organization presently have a state gaming license? ~ No 0 Yes - If "Yes," the organization is not eligible for a local permit or charity local permit and should call the Office of Attorney General at 1-800-326-9240, Has the organization received a charity local permit from this or another city or county for the fiscal year July 1 through June 30? gg No 0 Yes - If "Yes," the organization does not qualify for a local permit or charity local permit. Has the organization received a local permit from this or another city or county for the fiscal year July 1 through June 30? rn No 0 Yes - If "Yes," indicate the total value of all prizes previously awarded: $ , This amount is part of the total prize limit of$12,000 per year, Business Phone Number ;¡:;>-g -, / 7/