05-28-2003 Council Agenda - Laserfiche WebLink

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Minnesota Lawful Gambling Lawful Gambling Compensation Schedule - LG205 5/00 License number Organization name e /� r // / 4. 1 (-! l�� y�.r.Ck- (Y i -S' i'o Y / G c[-Q c50 G I G /-] o .j' 4% G L. it Business address of organization (do not use address of gambling manager) Street / /+ City // State/Zip code -5-75- �• . C / Li Ca via-c/a- ,Qc �, ,7 /e ea. n a. a/c /Y1 r./ -1.5 i / 7 Name of chief executive officer f . I re� \ En, i Business phone number I C a. r t r i , c , rJ o u a m (G.si ) si8f,• V 784 - Compensation Schedule • Compensation means wages, salaries, and all other forms of payment for services rendered in the conduct of lawful gambling. • Do not include wages paid to employees who do not participate in the conduct of gambling, (i.e., bookkeepers, accountants, attorneys). • If no wages are paid, state "No compensation paid ", sign the LG205, and attach it to the LG200A application. • When submitting an updated compensation schedule with changes, be sure to include the wages for all positions. Position/ /, Q,�j ! y, z Amount to be Paid For All Employees Enter the minimum and maximum wage of each position listed If employees are not paid (volunteers), indicate $0. Minimum Maximum and check the appropriate box. Check appropriate box . Per Occaslon Hourly Daily Weekly — 4(ontlily ‘ Other (specify) Gambling Manager $ $ ,><. 1 Assistant Gambling Manager, If $ $ any BINGO: Caller $ $ Checker(s) $ $ Sales - $ $ paper cards) $ $ Collectors (hard Other r(/((i�ideepntify): I /r OTHER THAN BINGO: Seller $ $ Seller $ $ . Other (identify): $ $ Signature I affirm that the lawful gambling compensation schedule for all employees is accurate and has been approved by our organization • changes in the compensation s ule will be submi/ttteed to the Board within len days of the change. - 6o11-uL id.-» --• l7, (.1"/ .2•3 / 1.. Chief exe... ive officers signature Date Mail to: Gambling Control Board Suite 300 South 1711 West County Road B Roseville, MN 55113 This form will be made available in alternative format (i.e. large print, Braille) upon request i you use a TTY you can call us by using the Minnesota Relay Service at 1- 800 -627 -3529 and ask to place a call to 651 - 6394000. The information requested on this form will become public information when received by the Board, and will be used to determine your compliance with Minnesota statutes and rules governing lawful gambling activities.