§ 901.191. License application form.
(a) The Department will proscribe the license application form for eligible organizations. Licensing authorities may obtain the form from the Department.
(b) The form is available to eligible organizations through the licensing authorities.
(c) The license application form must contain, at a minimum, the following information:
(1) The name of the organization.
(2) The type of organization.
(3) The address of the organization.
(4) Incorporation information.
(5) The name of the municipality where the applicant will maintain its licensed premises.
(6) The eligible organization’s licensed premises.
(7) The eligible organization’s operating day and week.
(8) The names, addresses and telephone numbers of the officers of the organization.
(9) Partnership information.
(10) A list of shareholders owning 10% or more of outstanding stock.
(11) The names and addresses of persons who will be responsible for the operation of games of chance, including eligible organization employees, bar personnel, auxiliary group members and other persons who will obtain the games of chance and coordinate their use.
(12) A statement under oath in the form of an affidavit, affirmed by the executive officer or secretary of the eligible organization, stating the following:
(i) A person 17 years of age or younger will not be permitted by the eligible organization to operate or play games of chance.
(ii) The facility in which games of chance are to be played has adequate means of ingress and egress and adequate sanitary facilities available in the area and meets Department of Health and other local or Federal sanitary requirements.
(iii) The eligible organization is the owner of the premises upon which the games of chance are played or, if it is not, the eligible organization is not leasing the premises from the owner thereof under an oral agreement, nor is it leasing the premises from the owner thereof under a written agreement at a rental which is determined by the amount of receipts realized from the playing of games of chance or by the number of people attending, except that an eligible organization may lease a location or premises for a banquet where a per head charge is applied in connection with the serving of a meal.
(13) A copy of a corporate applicant articles of incorporation and bylaws; or, if not a corporation, a copy of bylaws and other documents which set out the organizational structure and purpose.
(14) A copy of a nonprofit charitable applicant’s Internal Revenue Service tax exemption letter if one has been obtained and a copy of other documents indicating the eligible organization is a nonprofit charitable organization.
(15) The details and copies of the lease, rental or other arrangements between the applicant and the owner of premises upon which the games of chance will be conducted, if the premises are not owned by the eligible organization.
(16) The names, addresses, dates of birth and the Social Security numbers of each paid employee, auxiliary group member or agent who will be involved with the activities for which the license is sought.
(17) Other documents as identified in the application materials.
(18) The type of license applied for and a list of all types of games of chance to be operated by the eligible organization.
(19) A list of distributors of games of chance with whom the eligible organization does business.
(20) A list of the eligible organization’s auxiliary groups that will operate games of chance under the eligible organization’s license.
Source The provisions of this § 901.191 amended August 11, 2006, effective August 12, 2006, 36 Pa.B. 4475. Immediately preceding text appears at serial pages (265883) to (265884).
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