Form Cg-7 - Festival License Application - Indiana Department Of Revenue - 1996
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Indiana Department of Revenue
Form
License Fee Paid _____________
CG-7
Festival License Application
Date Received ______________
Rev. 6-96
Reviewed By ______________
SF-45385
Date Entered _______________
You must file this application at least six (6) weeks before your festival event.
1. Name of organization (please type or print)
STOP! Get Charity
Gaming Publication 2
2. Previous name of organization (if name changed)
for more information.
3. Street address of principal office (as it appears on the Charity Gaming Qualification Application, Form CG-1)
City
State
Zip Code
County
Daytime telephone number
(
)
4. On what dates (enter month/day/year) and during what hours will your festival event be conducted? (A.M. establishes the midnight hour,
P.M. establishes the noon hour.)
Date: ____________ 19__
Date: ____________ 19__
Date: ____________ 19__
Date: ____________ 19__
Date _________ 199__ Hours _______ __M to _______ __M
Date _________ 199__ Hours _______ __M to _______ __M
From:____________ __M
From:____________ __M
From:____________ __M
From:____________ __M
Date _________ 199__ Hours _______ __M to _______ __M
Date _________ 199__ Hours _______ __M to _______ __M
To:
____________ __M
To:
____________ __M
To:
____________ __M
To:
____________ __M
5. Street address of the facility where the festival event will be conducted and the DBA name (Doing Business As) if applicable.
City
State
Zip Code
County
Daytime telephone number
(
)
Attach additional sheets if necessary
Leasing Information
to supply all information for each line.
6. Does your organization own _____, lease (rent) _____, or use a donated _____ facility where the licensed event will be conducted? (Check
one.) If leased (rented), enter name and address of lessor and attach a copy of your signed lease agreement. If donated, attach a notarized
statement from the donor that the facility is being offered rent free. NOTE: Check this box
if the rented facility is being used for an
annual convention or other yearly meeting of your organization's (or your affiliate's) membership.
Name of Lessor (Full Legal Name)
Address
City
State
Zip Code
County
Daytime Telephone Number
(
)
7. Is any tangible personal property (i.e. tables, chairs, bingo blowers, roulette wheel, etc.) being leased or donated to you for this event?
Yes
No
If you answered yes, list below the name and address of the lessor or donor. Attach signed copy of the lease
agreement or donation statement from the donor.
Name
Address
City
State
Zip Code
8. Does your organization own bingo equipment? Yes
No
If you answered yes, list below the seller's name, date of purchase,
purchase price, and the type of equipment purchased.
Name of Seller
Date of Purchase
Purchase Price
Equipment Type
$
$
$
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