Gaming License Application - City Of Sparks
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1GAMING LICENSE APPLICATION
(Please Print)
Do You Have A Current City Of Sparks Business
License?
Today’s Date:
Yes
No
BUSINESS INFORMATION
Name Of Business:
Anticipated Start Date:
Sole Prop
Corporation
Partnership
LLC
DBA:
Business Address:
City/State:
Zip Code:
Mailing Address:
City/State:
Zip Code:
Email:
Business Phone:
Alt Phone:
(
)
(
)
APPLICANT INFORMATION
Name Of Applicant:
Birth Date:
Home Phone:
Cell Phone:
/
/
(
)
(
)
Yes
No
Do You Have A State Gaming License?
State License Number ____________________
Home Address:
City/State:
Zip Code:
LICENSE TYPE
Please Check The Box Which Corresponds With The Type Of Games You Are Applying For (Check All That Apply)
Please Note – All Gaming Licenses Are Prorated Daily From The Date Of Approval Through The Last Day Of The Quarter
ALL FEES ARE PER MACHINE/TABLE/GAME
Coin Operated Machines (Slots, Twenty One, Poker, Dice) - $30 Quarterly
Table Games (Faro, Chuck A Luck, Twenty One, Hazard, Big Six, Baccarat -$105
Quarterly
Roulette, Craps - $105 Quarterly
Bingo, Tango, Chinese Lottery - $150 Quarterly
Poker (Stud, Draw) - $75 Quarterly
Panguingui - $36 Quarterly
Keno, Race Horse Keno - $225 Quarterly
Race, House & Sports Book - $300 Quarterly
Poolrooms Where Percentages Are Taken - $90 Quarterly
Punchboards - $6 Quarterly
Sports Information Wire Under/Over $560 weekly - $90/$360 Quarterly
I, the undersigned, understand that: 1) It is unlawful for any person to transact or conduct any business without first having obtained a
Business License; 2) This document is an application for a Gaming License only and certain conditions must be met before A Gaming License
will be issued to me; 3) I certify that the information submitted on and with this form is true and correct to the best of my knowledge, and any
changes will be reported immediately.
Applicant Signature:
Date
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Parent category: Legal