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Home My WebLink About[04c] Gambling Permitcrrv oR s~: ac~M vn Council Agenda Item 4 C MEETING DATE: February 19, 2009 AGENDA ITEM: Gambling Permit -Requested Action: Accept the Gambling Application of the St. Cloud Heritage Quilters for an event to be held on October 3 - 4, 2009 at the College of St. Benedict, Clemens Field House. SUBMITTED BY: Administration BOARD/COMMISSION/COMMITTEE RECOMMENDATION: PREVIOUS COUNCIL ACTION: BACKGROUND INFORMATION: The City is required to accept all applications for lawful gambling within the City Limits. BUDGET/FISCAL IMPACT: ATTACHMENTS: Gambling Application REQUESTED COUNCIL ACTION: Accept the application of the St. Cloud Heritage Quilters for an event to be held on October 3 - 4, 2009 at the College of St. Benedict, Clemens Field House. February 12, 2009 St. Joseph City Council, Thank you for reviewing our application for an exempt permit. I look forward to hearing from you. Please call me at 320/355-2390 when you have made your decision. Sincerely, ,~ /r'Y. L. _ ~j ..~ Beth Probasco St. Cloud Heritage Quilter's Raffle Committee for 2009 Quilt Show 320/355-2390 11567 Sage Road Hillman, MN 56338 ~~I FEES ~ ~ 'L'U09 GfTY QF ST. ~i~JSEPH ~ ~Ii13Y.1~i ~tas~y~ess ~~tievva~ MINNESOTA SECRETARY OF STATE 2008 NONPROFIT CORPORATION ANNUAL RENEWAL Minnesota Statutes Chapter 317A Must be filed by December 31 Annual Renewal Filing Date: 08/06/2008 ST. CLOUD HERITAGE QUILTERS 125 16th Ave N St Cloud, MN 56303- CURRENT INFORMATION ON FILE: ~ File#: 1H-229 State of Incorporation: MINNESOTA { ~, )/ntit~~ Name: ST. CLUUU HERl7'AGE QU1L"1'ERS Registered Agenti Registered Office Address: [No Name Provided) i 12.5 ] 6th Ave N i St Cloud, MN 56303- ~ Previous Cun•ent Name of President: Name and Business Address of President: Lavonne Zeman Marv Proeii S13 2nd Avenue N Bartell MN 56377 Contact Information: Mary Proell ~ 320'--~~~ 02~~ -5338 1lLij.iJ.iiv..:~::.:;.ova.iu,cc:..~iui.:.i:;; :s ~:i i-~~i:1.:_:aiu:::ui ~.i.:ib..:oj_r.:.Y:,i~i .,:~-:~'.::,~,r..~b~ vi::-:: ax.i.ii:a~ii::... ~; ~s; ._v~::r 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 - awards less than $50,000 in prizes during a calendar year. Page 1 of 2 9/OS Fee is $50 for each event. For Board Use Only ('hark !t ORGANIZATION INFORMATION Organization name Previous gambling permit number St. Cloud Heritage Quitters -Club X-06762-07-001 Type of nonprofit organization. Check one. Fraternal ~ Religious a Veterans ~ Other nonprofit organization Mailing address City State Zip Code County 813 2nd Ave N Sartell MN 56377 Stearns Name of chief executive officer (CEO) Daytime phone number Email address Mary Proell 320-282-5338 xrayproell@hotmail.com Attach a copy of QN of the following for proof of nonprofit status. Check one. Do not attach a sales tax exempt status or federal ID employer numbers as they are not proof of nonprofit status. a Nonprofit Articles of Incorporation OR a current Certificate of Good Standing. Don't have a copy? This certificate must be obtained each year ftom: Secretary of State, Business Services Div., 180 State Office Building, St. Paul, MN 55155 Phone: 651-296-2803 a 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. 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 wilt be conducted (for raffles, list the site where the drawing will take place) College of St. Benedict -Clemens Fiel Address (do not use PO box) City Zip Code County 37 S. College Ave St. Joseph 56374 Stearns Date(s) of activity (for raffles, indicate the date of the drawing) 10-03-2009 to 10-04-2009 heck 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 Gambling Control Board. EXCEPTION: Bingo hard cards and bingo Page 2 of this form. 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 click on List Reset Form of Licensed Distributors, or call 651-639-4076. LG220 Application for Exempt Permit If the gambling premises is located in a township, a county official must check (X) the action that the county is taking on this application and sign the application. A township official must also sign the application. F K If the gambling premises is within city limits, a city official must check (X) the action that the city is taking on this application and sign the application. 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 fora 1st class city). _The application is denied. Print city name Jt - ~ ~S~ )°~ On behalf of the city, I acknowledge this application Signature of city official reEeiving~application 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 On behalf of the county, 1 acknowledge this application. Signature of county official receiving application Page 2 of 2 9/08 Title Date / / TOWNSHIP: On behalf of the township, I acknowledge that ~> / (,~ ~ the organization is applying for exempted gambling activity -' within township limits. [A township has no statutory authority to approve or deny an application [Minnesota Statute 349.2f 3, subd. 2)] Print township name Signature of township official acknowledging application Title Date / / ~ CHIEF EXECUTIVE OFFICER'S SIGNATURE ~ The information provided in this application is complete and accurate to the best of my knowledge. 1 acknowledge that the financial report will be completed and returned to the Board witlJi{- 30 days of the date of our gambling activity. Chief executive officer's signature Complete a separate application for each gamYing activity: - one day of gambling activity, -two or more consecutive days of gambling activity, - each day a raffle drawing is held Send application with: a copy of your proof of nonprofit status, and $50 application fee for each event. Make check payable to "State of Minnesota." To: Gambling Control Board 1711 West County Road B, Suite 300 South Roseville, MN 55113 Datep2 /1 p ~ Financial report and recordkeeping required A financial report form and instructions will be sent with your permit. Within 30 days of the activity date, complete and return the financial report form to the Gambling Control Board. Questions? Call the Licensing Section of the Gambling Control Board at 651-639-4076. Print Form Reset Form Data privacy. This form will be made available in alternative format (i.e. large print, Braille) upon request, The information requested on this form (and any attachments) will be used by the Gambling Control Board (Board) to determine your qualifications to be involved in lawful gambling activities in Minnesota. You have the right to refuse to supply the information requested; however, if you refuse to supply this information, the Board may not be able to determine your qualifications and, as a consequence, may refuse to issue you a permit. If you supply the information requested, the Board will be able to process your application. Your name and and your organization's name and address will be public information when received by the Board. All the other information you provide wAl be private data until the Board issues your permit. When the Board issues your permit, all of the information provided to the Board will become public. If fhe Board does not issue a permit, all information provided remains private, with the exception of your name and your organization's name and address which wiN remain public. Private data are available io: Board members, Board staff whose work requires access to the information; Minnesota's Department of Public Safety; Attorney General; Commissioners of Administration, Finance, and Revenue; Legislative Auditor, national and international gambling regulatory agencies; anyone pursuant to court order; other individuals and agencies that are 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 consent.