Form Taa-50g - Temporary Agency Agreement For County/city Lottery Licenses Page 2
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1
2INSTRUCTIONS
WHO MUST FILE. Any licensee who has agreed with a buyer
■ A completed application for the purchaser of the business
to sell the business where a county/city lottery license is held is
on Nebraska Schedule II - County/City Lottery Sales Outlet
to file the Temporary Agency Agreement for County/City Lottery
Location Application, Form 50G, must be on file with the
Licenses, Form TAA-50G. Both the licensee (seller) and the license
department, including the required attachments of a copy of
applicant (buyer) must provide the requested information and submit
the county, city, or village approval of the sales outlet location,
the completed Form TAA-50G to the Charitable Gaming Division of
a copy of the contract or lease between the lottery operator
the Nebraska Department of Revenue.
and the sales outlet location, and satisfying the fingerprinting
requirement for each individual who has an ownership interest,
WHEN AND WHERE TO FILE. When a change of ownership of
either directly or indirectly, in the applicant. If a spouse has no
a business licensed as a lottery operator or sales outlet location is
proprietary interest in the operation or profit derived from the
anticipated, the current owner of the lottery operator or sales outlet
activities of his or her spouse, a properly completed Affidavit
location may designate as his or her agent the party purchasing the
by Spouse for Waiver of Fingerprinting and/or Personal History
business. This would allow the buyer to begin operating the business
Record for Charitable Gaming License Application may be
prior to being fully licensed. To do so, a Form TAA-50G is to be filed
submitted instead of the fingerprint cards.
with the related county/city lottery application.
■ Form TAA-50G must be approved by the department and the
The completed Form TAA-50G must be mailed or delivered to the
copy returned to the sales outlet location is to be posted with the
Nebraska Department of Revenue, Charitable Gaming Division,
current license at the sales outlet location.
P.O. Box 94855, Lincoln, NE 68509-4855. If it is necessary to send
■ Throughout the duration of Form TAA-50G, the designated
the document by electronic facsimile, the original is to be mailed or
agent may operate the lottery using the current sales outlet
delivered to the department immediately.
location’s license. The licensed sales outlet remains fully
LINES 1 AND 2. Enter the name of the county, city, or village
responsible to the county, city, or village and to the lottery
as shown on the county/city lottery license posted at the business.
operator and the state for proper operation of the lottery until
If a joint lottery, please enter both names. Provide the Nebraska
such time as the new sales outlet location is licensed.
Identification Number of the county, city, or village as found on the
SIGNATURES. The licensee/license applicant must sign and date
existing license(s).
the form on the lines provided.
LINE 3. Check the appropriate box depending on whether this
If the licensee/license applicant is a partnership, all partners must sign
agreement is requested for a lottery operator or sales outlet location
unless one is duly authorized to act in the name of the partnership.
license(s).
Nebraska has adopted the Uniform Partnership Act (Section 67-
LINES 4 AND 5. The licensee must provide their Nebraska
309, R.R.S. 1996) which makes each partner a business agent duly
Identification Number and their Liquor License Number, if they
authorized to act for the partnership. This governs partnerships
hold a liquor license. In most situations, the Nebraska Identification
formed in the State of Nebraska. The validity of authorizations made
Number will be found on the sales tax permit for the premises.
by nonresident partnerships will be determined by the law of the
If the Nebraska Identification Number and/or Liquor License Number
state in which the partnership was formed.
have not yet been issued for the applicant, you may indicate applied
If the licensee/license applicant is a corporation or an association,
for. However, these numbers are normally issued when the sales tax
an officer having authority to bind the entity must sign. The officer
permit and liquor license applications are submitted. If you have not
must indicate his/her official title on the line provided.
submitted all of your applications yet, please do so promptly.
If the licensee/license applicant is a Nebraska limited liability
REQUIREMENTS TO QUALIFY AS AGENT FOR A
company, all members must sign unless a manager is duly authorized
LOTTERY OPERATOR: In order to be designated as an agent for
to act in the name of the limited liability company. The validity of
a lottery operator, the following criteria must be satisfied:
the authorizations made by a foreign limited liability company will
✔ A completed application for the purchaser of the business
be determined based on the law of the state in which the limited
on Nebraska Schedule I - County/City Lottery Operator
liability company was organized.
Application, Form 50G, must be on file with the department,
If the sales outlet location licensee/license applicant is a nonprofit
including the required attachments of a copy of the lottery
organization or a nonprofit corporation, the manager designated for
operator contract with the county, city, or village, the necessary
the liquor license/application must sign.
Personal History Record(s), Authorization(s) for Release of
NEBRASKA DEPARTMENT OF REVENUE APPROVAL.
Information, and satisfying the fingerprinting requirement for
Upon receipt of the properly completed Form TAA-50G and the
each individual who has an ownership interest, either directly
related county/city lottery application, the department will act on the
or indirectly, in the applicant. If a spouse has no proprietary
agreement and return it to the licensee/license applicant.
interest in the operation or profit derived from the activities of
his or her spouse, a properly completed Affidavit by Spouse
If Form TAA-50G is approved by the department, it will be mailed
for Waiver of Fingerprinting and/or Personal History Record
to the license applicant for posting at the business location.
for Charitable Gaming License Application may be submitted
If Form TAA-50G is not approved by the department, it will be
instead of the Personal History Record and fingerprint cards.
mailed to the licensee so they are aware they must continue to
operate the business.
✔ Form TAA-50G must be approved by the department and the copy
returned to the lottery operator or sales outlet location is to be posted
VALID PERIOD. For a lottery operator’s license, Form TAA-50G
with the current license at the lottery operator’s location.
is valid for a period not to exceed the shorter of (1) the expiration of
existing lottery operator’s license or (2) 180 days unless otherwise
✔ Throughout the duration of Form TAA-50G, the designated
extended in writing by the department prior to the expiration of the
agent may operate the lottery using the current lottery
180 days.
operator’s license. The licensed lottery operator remains fully
responsible to the county, city, or village and to the state for
For a sales outlet location’s license, Form TAA-50G is valid for a
proper operation of the lottery until such time as the new lottery
period not to exceed 120 days.
operator is licensed.
DIRECT QUESTIONS TO THE DEPARTMENT. Any questions
REQUIREMENTS TO QUALIFY AS AGENT FOR A SALES
on the application or completion of this form are to be directed to
OUTLET LOCATION: In order to be designated as an agent for a
the Charitable Gaming Division. Our toll free number is (877) 564-
sales outlet location, the following criteria must be satisfied:
1315.
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