Video Lottery Machine - Bill Of Sale

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Video Lottery Machine Bill of Sale
Sale of Video Lottery Machines (check applicable):
South Dakota Lottery
Complete Route Sale (between Operators)
711 E. Wells Avenue
Partial Route Sale (between Operators)
Pierre, SD 57501
Back to Distributor
605-773-5770
605-773-5786 or 773-6218 (faxes)
Seller:
Buyer:
Operator #_______
Operator #_______
Op. Name ___________________________
Op. Name ____________________________
Address _____________________________
Address ______________________________
___________________________________
_____________________________________
___________________________________
____________________________________
Signature/Title
Signature/Title
Machine Information
Serial #
Permit #
Manufacturer
Model #
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Dated this _________ day of ____________________, ________

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