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is �J Minnesota Lawful Gambling LG220 Application for Exempt Permit An exempt permit may be issued to a nonprofit organization that: - conducts lawful gambling on five or fewer days, and �M !eon ti—n t9m nnn in nri7P4z rl„rinn a calendar Year. Page 1 of 2 9108 Fee is $50 for each event For Board Use Only C:he& # ORGANIZATION INFORMATION Organization name Previous gambling permit number Irondale Marching Knights Band Booster Organic 3 r r1 !.� r o g Type of nonprofit organization. Check one. Fraternal FMReligious [a Veterans 0 Other nonprofit organization Mailing address City State Zip Code County PO Box 120283 New Brighton MN 55112 Ramsey Name of chief executive officer (CEO) Daytime phone number Email address William Sucha 651-621-6848 Bill.Sucha@moundsviewschools.org Attach a copy ofPNE of the following for proof of nonprofit status. Check one. Do not attach a sales tax exempt stratus or federal ID employer numbers as they are not 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., 180 State Office Building, St. Paul, MN 55155 Phone: 651-296-2803 IRS income tax exemption 1601(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 fails 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. IRS - proof previously submitted to Gambling Control Board If you previously submitted proof of nonprofit status from the IRS, no attachment is required. GAMBLING PREMISES INFORMATION Name of premises where gambling activity will be conducted (for raffles, list the site where the drawing will take place) Irondale High School Address (do not use PO box) City Zip Code�Ra County 2425 Long Lake Road New Brighton 55112 sey Date(s) of activity (for raffles, indicate the date of the drawing) 10I.31n9 to Check the box or boxes that indicate the type of gambling activity your organization will conduct: ❑ Bingo* ® Raffles [—] Paddlewheels* [] Pull -Tabs* [:]Tipboards* * Gambling equipment for pull -tabs, bingo paper, tipboards, and Also complete paddlewheels must be obtained from a distributor licensed by the page 2 of this form. Gambling Control Board. EXCEPTION: Bingo hard cards and bingo number selection devices may be borrowed from another organization authorized to conduct bingo. Print Form To find a licensed distributor, go to www.gcb.state.mn.us and dick on List Reset dorm. of Licensed Distributors, or call 651-639-4076.