HomeMy WebLinkAbout20100119 - VI-04To: Mayor Hicks and City Councilmembers
From: Adeline Schroeder, Deputy City Clerk
Date: January 12, 2010
Re: Application for Raffle-Knights of Columbus
Recommended City Council Action:
Approve the attached resolution; approving a.raffle for The Knights of Columbus at the
KC Hall, 30'75 Verrzii111ori Street_y Hastings;°:to be effective on Apri125; .201'0..
gack~round: -
The Knights of Coliml}us have paid the requireel,fees of:$1OQ0.
If Council should approve this application; the attached resolution will be sent: to the
Gambling Control Board showing the :City's :approval."
Should you have any concerns or questiaris;'please:do. nothesitate°to contact me
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CITY OF HASTINGS
DAKOTA COUNTY, MINNESOTA
RESOLUTION NO. O1- -10
RESOLUTION APPROVING THE APPLICATION BY
KNIGHTS OF COLUMBUS FOR A RAFFLE
WHEREAS, Knights of Columbus have presented an application to the City ofHastings for a
raffle for Apri125, 2010 at The KC Hall, 3075 Vermillion Street, Hastings; and;
WHEREAS, the Minnesota Gambling Control Board requires a resolution be passed to
approve the request; and
WHEREAS, an application for a raffle has been presented; and
WHEREAS, The Knights of Columbus have paid the required fees of $10.00.
NOW, THEREFORE, BE IT RESOLVED by the City Council of the City ofHastings that
the Mayor and City Clerk are authorized and directed to sign this resolution and forward to the
appropriate agency, showing the approval of this application.
Ayes:
Nays:
Absent:
Whereupon said resolution was declared duly passed and adopted on the 19~' of January 2010.
Melanie Mesko Lee, City CZeNk
Paul J. Hicks, MayoN
(SEAL)
Hastings Knights of Columbus Council 1600
3075 Vermillion St.
Hastings, MN 55033
The Knights of Columbus would like to hold a raffle on
Sunday April 25, 2010. The proceeds from the raffle will be used
towards our two, $600.00, Hastings High School Scholarships that
we award each year. We will be selling 1 SO tickets at $15.00 each.
The prizes will total $1990 for a profit of $1250.
Any questions I can be reached at 651-437-6400 days.
Thank you very much,
~ _.
Grego K sel chairperson
Page 1 of 2 7109
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_G220 Application for Exempt Kermit Application fee
lfa lica#ion ~ostmarkedorreceived:
An exempt permit may be issued to a nonprofit organization that:
- conducts lawful gambling on fve yr fewer days, and less than 30 days
before the event more than 30 days
before the event
-awards less than $50,000 in prizes during a calendar year. $'[00 $50
ORGANIZATION INFORMATION Check # $
Organization name .~ f ~ Previous gambling permit number
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Type of n nprofiit organization. Check one.
Fraternal ~ Religious ~ Veterans ~ tither nonprofit organization
Mailing address ,Cfify State dip Cade County
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Name of chief executive offi r (CEO) Daytime phone number IWmail address
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Attach a c py of ONE of a follavliing for proof of nonprofit status. C. heck one.
Do not attach a sales tax exempt status or federal ID employer numbers as they are not proof of nonprofit status.
^ Nonprofit Articles of Incorporation OR a current Certificate of Goad Sanding.
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Dnn
t have a copy? This certificate must be obtained each year from:
Secretary of State, Business Services Div., 180 Sta#e Office Building, St. Paul, MN 55155 Phone: 651-296-2803
IRS income tax exemption [50~1(c)] letter in yoar organization's name.
Dorr'# 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, ar 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 nonproft 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
Nam
e of p
remises where gambling activity will be conducted (for raffles
, list th
e site where the drawing will take place}
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Addre (do not use PO box) Gity Zip Cade County
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Date{s) of activity) (for raffles, indicate the date of the drawing)
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Check the box or boxes that indicate the type of gambling activity your organization will conduct:
t3ingo* 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. fria~t:Form
To find a licensed distributor, go to www,gcbstate.mn,us and click on List ResCt 1=otrn
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of Licensed Distributors, nr call 651-639-4076.
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LG220 Application for Exempt Permit
Page 2 of 2 7109
LOCAL UNIT Ol` GOVERNMENT ACKNOW LEDGMENT
!f the gambling premises is within city limits, If the gambling premises is located in a township, a
a city official must check the action that the city is county official must check the action that the county is taking
taking on this application and sign the application. on this application and sign the application.
A township official is not required to sign the application.
The application is acknowledged with no waiting period. The application is acknowledged with nn waiting period.
The application is acknowledged with a 3D day waiting The application is acknowledged with a 30 day waiting
period, and allows the Board to issue a permit after 30 period, and allows the Board to issue a permit after 3D
days (6D days fora 1st class city). days.
The application is denied. _The application is denied.
Print county name
Print city name On behalf of the county, 1 aclcnawledge thrs application.
On behalfafihe city, !acknowledge this application. Signature of county official receiving application
Signature of city official receiving application
Title Date / /
(Optional) TOWNSHIP; On behalf of the township, ]
Title Date / / 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 349.166)]
Print township name
Signature of township official acknowledging application
Title Date 1 1
CHIEF EXl<CUTIVE Qi=~1C~R'S SI NATURE
The information provided in this applrcation is omplete and accurate to the best of my tcnowledge. I acknowledge that the
financial report will be completed and retcrr d the Board wit 30 day of the date of our gambling a lolly
Chief executive officer's signature - O Date ~~~ ~Q
Complete a separate application for each gambi g activity: Fin ial report and recordkeeping required
- one day of gambling activity, A financial report form and instructions will be sent with
-two or mare consecutive days of gambling activity, your permit, or use the online fill-inform available at
- each day a raffle drawing is held www.gcb.state.mn.us. Within 3D days of the activity date,
Send application with: complete and return the financial report form to the
- a copy of your proof of nonprofit status, and Gambling Control Board.
-application fee for each event. Questions?
Make cheek payable tv "Sfate of Minnesota." Call the Licensing Section of the Gambling Control
To: Gambling Gontrol Board
Board at 651-639-4076.
1711 West County Road B, Suite 8DD South
Roseville
MN 55113
Print 1=ort~1 Rcs~t 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 he 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 ka 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 will be private
data until the Board issues your permit. When
the Board issues your permit, all of the
information provided to the Board will became
public, If the 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 will remain public.
Private data are available to: Board members,
Board staff whose work requires access to the
information; Minnesota's Department of Public
Safety; Attorney General; Commissicners of
Administration, Finance, and Revenue;
Legislative Audikor, national and international
gambling regulatory agencies; anyone pursuant
to court order; other individuals and agencies
that are specifically authorized by state or
federal law io 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.