Form Rcg-8 - Charitable Games Equipment Price List Page 2

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Step 2: List all charitable games equipment you will offer for sale, lease, or
distribution (continued)
Description
Quantity
Sale price
Rental or lease price
17
___________________________________
_______________
$_________________________ $_________________________
18
___________________________________
_______________
$_________________________ $_________________________
19
___________________________________
_______________
$_________________________ $_________________________
20
___________________________________
_______________
$_________________________ $_________________________
21
___________________________________
_______________
$_________________________ $_________________________
22
___________________________________
_______________
$_________________________ $_________________________
23
___________________________________
_______________
$_________________________ $_________________________
24
___________________________________
_______________
$_________________________ $_________________________
25
___________________________________
_______________
$_________________________ $_________________________
26
___________________________________
_______________
$_________________________ $_________________________
27
___________________________________
_______________
$_________________________ $_________________________
28
___________________________________
_______________
$_________________________ $_________________________
29
___________________________________
_______________
$_________________________ $_________________________
30
___________________________________
_______________
$_________________________ $_________________________
31
___________________________________
_______________
$_________________________ $_________________________
32
___________________________________
_______________
$_________________________ $_________________________
Step 3: Write the storage locations of the equipment listed in Step 2
Charitable games equipment must be stored separately from all other products, materials, or equipment. Write the storage locations of your
charitable games equipment below. Attach additional sheets if necessary.
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
Step 4: Sign below
Under penalties of perjury, I state that I will sell, lease, or distribute only the equipment listed in Step 2 at the price listed in Step 2 only to
organizations licensed to conduct charitable games in Illinois. I will notify the Illinois Department of Revenue before I offer additional items for
sale, lease, or distribution, or if any prices change. I will not alter or modify any of the equipment or own any altered equipment that gives the
possessor or operator of the equipment a greater chance of winning. I have examined this price list and, to the best of my knowledge, it is
true, correct, and complete.
_________________________________________________________________________(_____)________________________________
Responsible party’s signature
Daytime telephone
Date
RCG-8 back (R-5/97)
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