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L0200 Minnesota Lawful Gambling <br /> Rev. (2/28/90) Gambling License Application - Part 1 <br /> Organization Information ;::..:: <br /> Legal name of organization • <br /> SAINT ANTHONY VILLAGE SPORTS BOOSTERS <br /> Business address of organization-Street or P.O Box (Do t use address of gambling manager) <br /> 33c( Sig yc-x 1,4 Ke oqb <br /> City State Zip Code County Business phone number <br /> _s7. 4j " �� s�'4�� 1WAA=W1, 1 V!z) 7e —sb 2.r <br /> Name of chief execuc a officer(cannot be gambling manager) Title Business phone number <br /> .4-x (a 1?- ) 416-121-,710 <br /> Address of chief executive officer-Street or P O x <br /> City State Zip Code County <br /> Name of treasurer or person responsible for organization's other revenues(cannot be gambling manager) Title Business phone number <br /> NHS OC',4 aG-9LQZ' <br /> Type of organization: ❑ fraternal ❑ veterans ❑ religious other nonprofit <br /> Number of years organization has been in existence as a nonprofit organization .2¢ <br /> Attach a copy of nonprofit incorporation from the Minnesota Secretary of State or a letter from the IRS declaring income tax <br /> exemption. (Do not send a sales tax permit or Federal employer identification information)) <br /> Number of active members �(must be age 18 and older) <br /> Fi,e5r Ww-'D craw( <br /> When does the organization hold regular meetings? Day(s) or &-4c14 /YfovT4 Hours 8:oo p,y- //:oo AN- <br /> Have internal controls been submitted on the form provided by the board? 4 yes ❑ If no--Attach a copy. <br /> Type o f A ii cat i <br /> PP <br /> on <br /> Class of License <br /> ❑ Class A—Fee$200(bingo, raffles, paddlewheels,tipboards,pull-tabs) <br /> a Class B—Fee$125 (raffles, paddlewheels,tipboards,pull-tabs) <br /> ❑ Class C—Fee$100(bingo only) <br /> ❑ Class D—Fee$75(raffles only) <br /> Bingo Occasions <br /> 11 Class A or C, fill In days and hours of bingo occasions: <br /> No more than six bingo occasions may be conducted by an organization per week <br /> Day Beginning/Ending Hours Day Beginning/Ending Hours Day Beginning/EndingHours <br /> to to to <br /> to to to <br /> to to to <br /> If bingo will not be conducted,check here <br /> Status of license -check one: <br /> ❑ Organization has never been licensed. <br /> New she—Fill in hm license number -O 2- oo/ <br /> ❑ Renewal of existing license—Fill in complete license number <br /> ❑ Chanoe in class of existing license—Fill in complete license number <br /> ❑ Previously expired license-Fill in complete license number <br /> • <br />