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HomeMy WebLinkAboutResolution 2012-37 - Approve Charitable Gambling St Thomas ChurchCity of Corcoran County of Hennepin State of Minnesota RESOLUTION NO. 2012 -37 Motion By: Milbrandt Seconded By: Gmach July 26, 2012 A RESOLUTION APPROVING CHARITABLE GAMBLING IN THE CITY OF CORCORAN, MINNESOTA BE IT RESOLVED, by the City Council of the City of Corcoran that the following Charitable Gambling License is granted effective for the dates as indicated, to the following Licensee, provided appropriate application and insurance documents are submitted and satisfactory background check completed by the Corcoran Police Department, LICENSEE LICENSE LICENSE EFFECTIVE DATE St. Thomas The Apostle VOTING AYE ® Guenthner, Ken ® Asleson, Rich ® Cossette, Tom ® Gmach, George ® Milbrandt, Rosalyn Charitable Gambling August 19, 2012 VOTING NAY ❑ Guenthner, Ken ❑ Asleson, Rich ❑ Cossette, Tom ❑ Gmach, George ❑ Milbrandt, Rosalyn Whereupon, said Resolution is hereby declared adopted on this 26th day of July 2012. Kenneth Guenthner - Mayor 2 EST: , eanie Heinecke — City Clerk Page I of I City Seal MINNESOTA LAWFUL GAMBLING LG220 Application for Exempt Permit 6/12 Page 1 of 2 An exempt permit may be issued to a nonprofit organization that: Application fee - conducts lawful gambling on five or fewer days, and If application posted or. received: - awards less than $50,000 in prizes during a calendar year, less than 30 days more tha 0 days If total prize value for the year will be $1,500 or less, contact before the event before the event the licensing specialist assigned to your county. $100 $50 f t A Organization name Previous gambling permit number p Minnesota tax ID number, if any Federal employer ID umber (FEIN), if any I-- / . Type of nonprofit organization. Check one. ElFraternal WReligious Veterans Other nonprofit organization Mailing address City State Zip code County 100 � � L) ai 0 n 5763$10 -nu .i f Name of chief executive officer [C O] Daytime phone number E -m it address el - 0av VONPROT3SST,a4 5''t '. � � Yn'�i °�i,�1���zUY"'..a Attach a copy of ONE of the following for proof of nonprofit status. Nonprofit Articles of Incorporation OR a current Certificate of Good Standing. Don't have a copy? This certificate must be obtained each year from: Secretary of State, Business Services Div., 60 Empire Drive, Suite 100, St. Paul, MN 55103 Phone: 651 - 296 -2803 IRS income tax exemption [501(c)] letter in your organization's name. Don't have a copy? To obtain a copy of your federal income tax exempt letter, have an organization officer contact the IRS at 877 - 829 -5500. IRS - Affiliate of national, statewide, or international parent nonprofit organization [charter] If your organization falls under a parent organization, attach copies of both of the following: a. IRS letter showing your parent organization is a nonprofit 501(c) organization with a group ruling, and b. the charter or letter from your parent organization recognizing your organization as a subordinate. w 1 11,1111, v w ,.., BLI NG al � � AN Name of premisq ihpeere the gambling event will be conducted. For raffles, list the site where the drawing will take place. es l f 1 _( Address [do not use PO box] dity or township Zip code County o caa Cca t) 0 i 6.d i-a e /I 1),e ai, ' "y Dates] of activity. For raffles, indicate the date of the drawing. Check each type f gambling activity that your organization will conduct. Bingo* ___X_. Raffle Paddlewheels* Pull -tabs* Tipboards* *Gambling equipment for bingo paper, paddlewheels, pull -tabs, and tipboards must be obtained from a distributor licensed by the Minnesota Gambling Control Board. EXCEPTION: Bingo hard cards and bingo number selection devices may be borrowed from another organization authorized to conduct bingo. To find a licensed distributor, go to www.gcb.state.mn.us and click on Distributors under the WHO'S WHO? LIST OF LICENSEES, or call 651- 639 -4000. LG220 Application for Exempt Permit CITY APPROVAL for a gambling premises located within city limits Y—The application is acknowledged with no waiting period. The application is acknowledged with a 30 day waiting period, and allows the Board to issue a permit after 30 days [60 days for a 1st class city]. _The application is denied. Print city name" Sig atur f city p`erso I, Title I7't/ �( r Date1 6/12 Page 2 of 2 COUNTY APPROVAL for a gambling premises located in a township The application is acknowledged with no waiting period. The application is acknowledged with a 30 day waiting period, and allows the Board to issue a permit after 30 days. The application is denied. Print county name Signature of county personnel Title Date TOWNSHIP -If required by county. On behalf of the township, I acknowledge that the organization is applying for exempted gambling activity within the township limits. [A township has no statutory authority to approve or deny an application, per Minnesota Statutes 349.166.] Print township name Signature of township officer Title Date The inforration provided in this application is complete and accurate to the best of my knowledge. I acknowledge that the financial report will be completed and returned to Board within 30 days of the event date. ,< r� Chief executive officer's signature ate®` Print name Complete a separate application for: - all gambling conducted on two or more consecutive days, or - all gambling conducted on one day. Only one application is required if one or more raffle drawings are conducted on the same day. Send application with: a copy of your proof of nonprofit status, and _ application fee. Make check payable to "State of Minnesota." To: Gambling Control Board 1711 West County Road B, Suite 300 South Roseville, MN 55113 Data privacy notice: The information requested on this form (and any attachments) will be used by the Gambling Control Board (Board) to determine your organization's qualifications to be involved in lawful gambling activities in Minnesota. Your organization has the right to refuse to supply the information; however, if your organization refuses to supply this information, the Board may not be able to determine your organization's qualifications and, as a consequence, may refuse to issue a permit. If your organization supplies the information requested, the Board will be able to process the application. Your organization's name and address will be public information when received by the Board. Financial report and recordkeeping required A financial report form and instructions will be sent with your permit, or use the online fill -in form available at www.gcb.state.mn.us. Within 30 days of the event date, complete and return the financial report form to the Gambling Control Board. Questions? Call the Licensing Section of the Gambling Control Board at 651- 639 -4000. This form will be made available in alternative format (i.e. large print, Braille) upon request. All other information provided will be pri- vate data about your organization until the Board issues the permit. When the Board issues the permit, all information provided will become public. If the Board does not issue a permit, all information provided remains private, with the exception of your organization's name and address which will remain public. Private data about your organization are available to: Board mem- bers, Board staff whose work requires access to the information; Minnesota's Department of Public Safety; Attorney General; Commissioners of Administration, Minnesota Management & Budget, and Revenue; legislative Auditor, national and international gambling regulatory agencies; anyone pursuant to court order; other indi- viduals and agencies specifically authorized by state or federal law to have access to the information; individuals and agencies for which law or legal order authorizes a new use or sharing of information after this notice was given; and anyone with your written consent.