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Minnesota Lawful Gambling <br />Lawful Gambling Compensation Schedule - LG205 <br />11197 <br />Organization Information <br />Organization name <br />2.4A/(4,0/4- Z c e• ty / n/ G <br />License number <br />Business address of organization (do not use address of gambling manager): <br />Street City State/Zip code <br />�-,s- c` ../#/ ca.nd. dam. &. L, i74/ C,a.rt,ad& /vl,✓ 55,/7 <br />Name of chief executive officer <br />AJ U LICr_ Y1 <br />Compensation Schedule <br />Business phone number <br />'J 7 4 - 5 - <br />6 5/) y8'- ./78.5 <br />� r 1. <br />„ �,- +�, <br />If employees are not paid (volunteers), indicate $0. <br />Per bingo occasion OR Per hour OR Other rate of pay <br />month <br />week <br />year <br />other <br />Gambling Manager $ $ / 0 , 0 0 $ <br />Assistant Gambling <br />Manager, if any $ $ $ <br />BINGO Caller $ $ $ <br />Checker(s) $ $ $ <br />Sales - paper $ $ $ <br />Collectors (hard cards) $ $ $ <br />Other (identify) <br />OTHER THAN BINGO <br />Seller $ $ $ <br />Seller $ $ $ <br />Other (identify) <br />$ $ $ <br />Signature <br />I affirm that the lawful gambling compensation schedule for all employees is accurate and has been approved by our <br />organization. Any changes in the schedule will be submitted to the Board within ten days of the change. <br />ief executive officer's signature <br />//L�.a•- <- iC�.....Z- <br />i S i97 <br />Date <br />Mail to: Gambling Control Board <br />Suite 300 South <br />1711 West County Road B <br />Roseville, MN 55113 <br />This form will be made available in alternative format (i.e. large print, Braille) upon request. <br />If you use a TTY, you can call us by using the Minnesota Relay Service at 1- 800.627 -3529 <br />and ask to place a call to 651 -639 -4000. The information requested on this form will become <br />public information when received by the Board, and will be used to determine your <br />compliance with Minnesota statutes and rules governing lawful gambling activities. <br />PAGE 205 <br />