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01/10/2002 09:55
<br />6516363070
<br />ESSENTIAL BUSINESS D PAGE 06
<br />Minnesota Lawful Ganibfifi
<br />Lawful Gambling. Gr
<br />i sli:salticin Schedule -
<br />5/00
<br />Organization name • License' number
<br />North'Suburban Youth rotin.lai` t; k: A- 01435
<br />Business address of organiiaticn'M6;. t; -'ue0, address of gambling manses!)
<br />Street • City State/Zip code
<br />1970 Oakerest Ave. Suite 11'qq. ^': Y.. Roseville MN. ' • 55113
<br />Name of chief executive officer. : ,Y,.,. "T�
<br />� Busineae phone number
<br />E.. (Richard) Robert Matson,:,:';-; ^::. ( 651 ) 789-8171
<br />Compensation $chodulo ;:`1;: : :..'' •
<br />.Compensatlon means waglie,,s2lati ,°Muiid:'all other forms pf 'payment ,for services rendered in the conduct of lawful
<br />gamblinrq. ,::.....
<br />• Do not include wages paid,B6; chi io' • who do not participate. in the conduct of gambling, (i.e., bookkeepers,
<br />aocountante,, attorneys), ` p'.: '';'••
<br />• If no wages are •pall, sfatn,'YJrz'ri(gi, ' gzillo,i, paid ", 8ipii •tho L.G205,' and attach it to the LG200A ripplIcetton. .
<br />• When submltbng an updated:, d0.41r l(66:sehoriule, with, changes, he sum to IncIudc the wages for an panmdns.
<br />'• Position µ' Amount to bo Paid For All Employees
<br />•
<br />Enter the minimum and rrtimtmury' ..04.0 ;iegbh position listed
<br />if employees are not petd (voluriteeis)( i'rtdrCate•$0. � ,
<br />' • : --z:' '
<br />litl*N , • M ebiTIgl . •
<br />Gambling Manager ' • y40;0QQ C1;0:;i,; 45,000.00
<br />and check
<br />.
<br />•
<br />Check ::
<br />DaPaoalOnlel
<br />:...
<br />the
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<br />• r•n a
<br />®�..
<br />IIIII
<br />I.■
<br />e���g
<br />appropriate bdx
<br />bo x
<br />may el Monthl
<br />.
<br />(Mar a.ael
<br />Annual
<br />MIN
<br />" ,....
<br />Assistant Gel blrng •
<br />Manager, if any
<br />BINGO: floor assistant � '. 1 0.00, "' '�j'�:` , �'
<br />caner $::.':'.:.:. 12.00
<br />fl_Checcer(s)
<br />fl
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<br />iiiiii
<br />2.1'0 23.00
<br />Sates - paper 6:q. 32.00
<br />■ �
<br />Collectors (hard cards) g . "'15i,04• %..g.., :18.00
<br />• rk • 15M(11.. '.: • 39.00,.
<br />Other pdentlf� tY
<br />Ei,()JXliS5i0ZtClerk ,� '., •,�•S;;!).Q�;;�:� ...19.00,:
<br />'
<br />Trainee 15,66 °::;; " .17.00.
<br />OTtERTHAN BINGO:
<br />, Seiler
<br />6`...ti • ••19.0U• •
<br />r Sei $—
<br />© '2.0@ t% u .;
<br />. . .
<br />` tl..isl Labor ' ;al 12.00 .
<br />ile s
<br />WY WO ii•ilIIN
<br />?fee eNS q -7f.
<br />Signature '.
<br />I affirm that the dawtul : gambling' :6em is�tion'..sehedule for al( - empl »yees' le 'accurate and -has been approved by our
<br />. organ %mien.,, Any cchange in the cai(pef,'sifatldn schedule will be submitted to the Board within ten days of the change,
<br />Chief e,te i five officers signature :, ,.
<br />g ..........,.. Date
<br />Gambling Control Board'
<br />Suite 300 South :
<br />1711 West County RoadI
<br />Roseville, MN; 55113'
<br />t&tdmS will be made avaitable'Iri alternative format (Le. largo print, Beadle) upon request. 1
<br />pitsisestri;, you ean'cell us by. using the Minnesota Relay Service at I- 800. 6274529 and
<br />,apigta ptaoaa can to661.639-0000:'Te Information'requasted on this form will become public
<br />':4 Y r61711a11on when-received by the•fioard, and will be used to determine your compliance with
<br />' ,frl{fnasgtg statutasand'rules governing lawful gambling actWities,
<br />
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