Gaming License Application Form Page 2

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If granted the license applied for, I/we will conduct the establishment in accordance with the provisions of the
laws of the United States pertaining to the State of Nevada, and the ordinances of the City of Henderson,
applicable to the conduct of such business, and that such application is made upon the express condition that if
such license be granted it shall be subject to revocation in accordance with the provisions of the ordinance.
Signature of Applicant:
Date:

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