HomeMy WebLinkAbout20101206 - VI-06To: Mayor Hicks & City Councilmembers
From: Adeline Schroeder, Deputy City Clerk
Date: November 19, 2010
Item: Temporary 1 Day Gambling Permit for Knights of Columbus Council 1600
Council Action Requested:
Approve the attached resolution approving a one day temporary gambling permit for May 1, 2011
for Hastings Knights of Columbus Council 1600, 3075 Vermillion Street, Hastings
Background Information:
Hastings Knights of Columbus Council 1600 have submitted an application for a one day
gambling permit for May 1, 2011.
Financial Impact:
Hastings Knights of Columbus Council 1600 has paid the appropriate fee of $10.00
Advisory Commission Discussion:
N. /A
Council Committee Discussion:
N/A
Attachments:
• Resolution
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City Council Memorandum
CITY OF HASTINGS
DAKOTA COUNTY, MINNESOTA
RESOLUTION NO. 12- -10
RESOLUTION APPROVING THE APPLICATION BY
KNIGHTS OF COLUMBUS FOR A ONE DAY RAFFLE
WHEREAS, Knights of Columbus have presented an application to the City ofHastings for a
raffle for May 1, 2011 at The Knights of Columbus 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:
2010.
Whereupon said resolution was declared duly passed and adopted on the 6 th of December
Melanie Mesko Lee, City Clerk
Paul J. Hicks, Mayor
(SEAL)
I % a i Jgei ! s
Paae I of 2 7/10
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L G220 Application for Exempt Perm
A p p licati on fee f each ev ent
If armlication postmarked or received:
less than 30 days
before the event
more than 30 days
before the event
An exempt permit may be issued to a nonprofit organization that:
- conducts lawful gambling on fire or fearer d and
awards less than $50,000 in prizes during a calendar year.
$100
$0
O RGANIZATION INFORMATION heck #
r, ani tion name Previous gambling permit number
co &0 (Cq vnc, a (0�0
S
Type of n refit or ani a tion. Cheep one.
❑ Fraternal El Religious 1:1 Veterans El Other nonprofit organization
Mailing address city State Zip Code County
30 -7 "5 - i �� _ge) -3 3 d
f
Name of chief executive officer (CEO) Dayti a phone number Email address
RM rZ.... JWT Z&� 1�k P ? /.'� 51 Z - gw
Attach a copy of ONE of .the following for proof of nonprofit status. Check one.
D o 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 Good Standing.
Don't have a copy? This certificate must be obtained each year from-
ecretary of State, Business Services D iv., 180 State Office B uildin g, Bt. Paul, MN 5515 Phone. 651- 296 -2803
1 RS incorrre tax e xem p tlon [5 01(e)] le er in your organs ation 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 - 520 - 5500.
I RS - Affl Hate of national, statewide, o r 1 nte rnation a I parent nonprofit organization (charter)
If your organization falls under a parent organization, attach copies of bath of the following:
a. II S 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 Gam bl1ng Control Board
If you previously submitted proof of nonprofit status from the IRS, no attachment is required.
GAMBLING PREMISES INFORMATI
Name of premises where gambling activity will be conducted (for raffles, list the site where the dray, ing wilt tape place)
k1 h I q k4s - lbao
Addre do not use PCB box) ity Zip Code County
9.1t % R
11 4 0-S
3 0 7,5 L/—e cm , t Vq I
Date(s) of activity (for raffles, indicate the date of the drawing)
M 0
Check the box or bones that indicate the type of gambling activity your organization will conduct:
Bingo* baffles El Paddlewh eels* [Pull -- Tabs* F]Tipboards*
* Gambling equipment for pull -tabs, bingo paper, tipboards and Also complete
�
paddlewheels rust b obtained from a distributor licensed bar the
G ambling Control Board. EXCEPTION: Bingo hard cards and bingo Page of this form.
number selection devices may be borrowed from another organization
authorized to conduct bingo. :Pr.1n t. F ar
:. or m.,
To find a licensed distributor, go to vvww.gcb.state.mn.us and click on List =1:.::
Re S 12�t
of Licensed Distributors or call 651 - 639 - 4000.
I
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-bOj
LG220 Application for Exempt P lr it
Page 2 of 2 1l10
I LOCAL UNIT OF GOVERNMENT ACKNOWLEDGMENT
If the gambling premises is within city limits,
city official must check 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 0 days for a 1st class city).
The application is denied.
Print city name
O n behalf of the city, 1 acknowledge this application.
Signature of city official receiving application
If the gambling premises is located in a township,
county official must check the action that the county is taking
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 acknowledg 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, ! acknowledge this application.
Signature of county official receiving application
C omplete a separate application for each gguffiing 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
- application fee for each event.
Make check payable to "State of Minnesota."
To: Gambling Control Board
1711 Hiles! County Road B, Sui 300 South
Roseville, Mid 551
Financial report and records eeping required
A financial report farm and instructions will be sent with
your permit, or use the online fill -in form available at
www.gcb.state.mn.us. Within 30 days of the activity date,
complete and return the financial report farm to the
Gambling C ontrol Board.
'Print- Form.. Reset E�rm
This form will be made available in alternative
format (i.e. lame p(nt, Braille) upon request.
Data privacy notice:The information requested
on this farm (and any attachments) will be used
by the Gambling Control Board (Board) to
determine your organization's qualifications to
be involved in lawful gambling activities in
Minnesota. Your organization has the right to
refuse to supply the information requested;
however, if your organization refuses to supply
this information, the Board may not be able to
determine your organization's qualifications
and, as a consequence, may refuse to issue a
permit. If you supply the information requested,
the Board will be able to process your
organization's application. Your organization's
name and address will be public information
when received by the Board. All other
information provided will be private data until
the Board issues the permit. when the Board
issues tine permit, all information provided will
become public. If the Board does not issue a
permit, all information provided remains private,
with the exception of your organization's name
and address which will remain public. Private
data are available to: Board mernbers, Board
staff w hose work requires access to the
information; Minnesota's Department of
Public Safety; Attorney General; .
ommissioners of Admin €stration, Minnesota
Management & Budget, and Revenue; -
Legislative Auditor, national and international
gambling regulatory agencies; anyone pursuant
to court order; other individuals and agencies
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 written
consent.
Title Date ! 1
(Optional) TOWNSHIP: O behalf of the township, l
Title Date 1
acknowledge that the organization is applying fDr 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 officia[ acknowledging application
Title plate
CHIEF EXECUTI E 'OFFICER'S SIGNATURE
The information provided in this appic tion ' coax acrd accurate to e best of my knowledge. 1 acknowledge that the
financial report will be completed and tum o e oa within 30 ys of the elate of our gambling activity.
l o
Chief executive officer's i na r el
Dante
C omplete a separate application for each gguffiing 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
- application fee for each event.
Make check payable to "State of Minnesota."
To: Gambling Control Board
1711 Hiles! County Road B, Sui 300 South
Roseville, Mid 551
Financial report and records eeping required
A financial report farm and instructions will be sent with
your permit, or use the online fill -in form available at
www.gcb.state.mn.us. Within 30 days of the activity date,
complete and return the financial report farm to the
Gambling C ontrol Board.
'Print- Form.. Reset E�rm
This form will be made available in alternative
format (i.e. lame p(nt, Braille) upon request.
Data privacy notice:The information requested
on this farm (and any attachments) will be used
by the Gambling Control Board (Board) to
determine your organization's qualifications to
be involved in lawful gambling activities in
Minnesota. Your organization has the right to
refuse to supply the information requested;
however, if your organization refuses to supply
this information, the Board may not be able to
determine your organization's qualifications
and, as a consequence, may refuse to issue a
permit. If you supply the information requested,
the Board will be able to process your
organization's application. Your organization's
name and address will be public information
when received by the Board. All other
information provided will be private data until
the Board issues the permit. when the Board
issues tine permit, all information provided will
become public. If the Board does not issue a
permit, all information provided remains private,
with the exception of your organization's name
and address which will remain public. Private
data are available to: Board mernbers, Board
staff w hose work requires access to the
information; Minnesota's Department of
Public Safety; Attorney General; .
ommissioners of Admin €stration, Minnesota
Management & Budget, and Revenue; -
Legislative Auditor, national and international
gambling regulatory agencies; anyone pursuant
to court order; other individuals and agencies
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 written
consent.
Hastings Knights of Columbus Council 1600
3075 Vermillion St.
Hastings, MN 55033
The Knights of Columbus would like to hold a raffle on
Sunday May 01, 201 1. 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 180 tickets at $18.00 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,
2
1 Grego set 4chairperson