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9 <br />0 <br />10 <br />Minnesota Lawful Gambling Page 1 of 2 6108 <br />L-62-20 Appncailon ror Exempt Permit <br />For Board Use Only <br />Check# <br />An exempt permit may be issued to a nonprofit organization that: Fee IS $50 for <br />• conducts lawful gambling on five or fewer days, and <br />• awards less than $50,000 in prizes during a calendar year. each event <br />$ <br />bRGAN12AFIOKI iNF,ORMAtm <br />Organization name - <br />Previousamblin <br />g g permit number <br />New Brighton Eagles Auxiliary # 3718 <br />X - 3930 <br />Type of nonprofit organization. Check N) one. <br />® Fraternal ❑ Religious ❑ Veterans ❑ Other nonprofit organization <br />Mailing address <br />City <br />State/Zip Code <br />County <br />563 Old Highway 8 NW <br />New Brighton <br />Mn 55112 <br />Ramsey <br />Name of chief executive officer (CEO) <br />Daytime phone number <br />Nancy Wadsworth <br />651 636 9525 <br />ATTACH A cot* OF ONIk F THE FOLLOWING FOR PROOF OF'`NONPAOFIT STATUS <br />* Do not attach a sales tax exempt status or federal ID employer numbers as they are not proof of nonprofit status. <br />_ Nonprofit Articles of Incorporation OR a current Certificate of Good Standing. <br />Don't have a copy? This certificate must be obtained each year from: <br />Secretary of State, Business Services Div., 180 State Office Building, St. Paul, MN 55155 Phone: 651-296-2803 <br />Internal Revenue Service - IRS income tax exemption [501(c)] letter in your organization's name. <br />Don't have a copy? To obtain a copy of your federal income tax exempt letter,have an organization officer <br />contact the IRS at 877-829-5500. <br />_Internal Revenue Service -Affiliate of national, statewide, or international parent nonprofit organization (charter) <br />If your organization falls under a parent organization, attach copies of both of the following: <br />a. IRS letter showing your parent organization is a nonprofit 501(c) organization with a group ruling, and <br />b. the charter or letter from your parent organization recognizing your organization as a subordinate. <br />glnternal Revenue Service -proof previously submitted to Gambling Control Board <br />If you previously submitted proof of nonprofit status from the Internal Revenue Service, no attachment is required. <br />-GAMBLIN:G PREM]S'ES INFORMATION <br />Name of premises where gambling activity will be conducted (for raffles, list the site where the drawing will take place) <br />New Brighton Eagles Club <br />Address (do not use PO box) <br />City <br />Zip Code <br />County <br />563 Old Hwy 8 NW <br />New Brighton, Mn <br />55112 <br />Ramselz <br />Date(s) of activity (for raffles, indicate the date of the drawing) <br />Check the box or boxes that indicate the type of gambling activity your organization will conduct: <br />❑ `Bingo ® Raffles ❑ 'Paddlewheels ❑ `Pull -Tabs ❑ `Tipboards <br />* Gambling equipment for pull -tabs, bingo paper, tipboards, and paddlewheels must <br />be obtained from a distributor licensed by the Gambling Control Board. - <br />EXCEPTION: Bingo hard cards and bingo number selection devices may be borrowed - <br />from another organization authorized to conduct bingo. <br />To find a licensed distributor, go to www.gcb.state.mn.us and click on List of Licensed <br />Distributors, or call 651-639-4076. <br />