Sd Eform 1338 - Application For License To Distribute Bingo And Lottery Equipment And Supplies - South Dakota Department Of Revenue

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SD EForm -
1338
V1
HELP
South Dakota
Department of Revenue
Application For License To Distribute Bingo And Lottery Equipment And Supplies
For the year ending December 31, __________.
Please type or print clearly
1. Owner/Operator name - enter name of sole proprietor,
Sales Tax Number
partnership, or corporation.
2. Business/trade name-if different than above
Telephone Number
3. Mailing address of business
Street of P.O. box
City
State
Zip
4. Location address of business-if different than above
Street of P.O. box
City
State
Zip
5. Type of business:
Sole Proprietorship
Partnership
Corporation
6. Identify owner(s), partners or corporate officers
Name
Address
City
State
Zip
7. List names of directors, managers and supervisors
Note: A distributor personnel information form must be completed by any owner, officer, director, partner or
manager/supervisor.
8. List address of each office, warehouse or outlet (if different from No. 3 or No. 4 above) where bingo/
lottery equipment and supplies are kept.
Address
City
State
Zip
01/03

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