Laserfiche WebLink
9. In whose custody will organization records be kept? <br />Name Address <br />10. If the organization carries sufficient insurance to compensate the players in <br />the event any injury is sustained by players while participating in the bingo <br />game, or while on the licensed premises, please state the <br />Name of Insurer and Policy No. <br />11. Have (Manager & Officer) read and do you thoroughly understand the provisions <br />of all laws, ordinances, and regulations governing the operation of bingo games? <br />12. Attach a list of all active members of the organization. <br />13. Copies of the following must be attached: <br />a. $10,000 fidelity bond on gambling manager. MN Statutes 349.17(7) <br />b. IRS Form No. 990 or 990 -T, whichever is applicable. <br />c. Copy of lease agreement. <br />d. If charitable organization, a statement of Bingo Operations. <br />MN Statutes 349.21(d) <br />Subscribed and sworn before me a <br />notary public on this <br />Day of 19 <br />Signature of Notary Public <br />Commission expires on <br />Subscribed and sworn before me a <br />notary public on this <br />Day of 19 <br />Signature of Notary Public <br />Commission expires on <br />Signature of authorized officer of <br />organization <br />Date <br />Signature of designated bingo manager <br />Date <br />Page -3- <br />