Instructions For 2013 Alaska Amended Permit Application
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1
2Instructions for 2013 Alaska Amended
Permit Application
Complete only sections that have changed.
Legal Questions
Use the amended permit application to correct errors
If you answer “yes” to either question, you must submit the
or make changes to information submitted on your
person’s name, date of birth, social security number and
organization’s original 2013 permit application form. Please
position of responsibility.
allow three to four weeks for your amended application to
be processed.
Signature
The signatures of two individuals are required. If the
Note: If you add a game type or change locations you
person signing as the primary or alternate member is also
must submit a copy of the completed amended permit
the organization’s president, then another officer of the
application to the municipality or borough where the new
organization must sign the application.
gaming activities will occur.
Facility-Based Games
Organization Information
List your organization’s federal employer identification
Add or delete a facility by checking the appropriate box and
completing all information requested in the boxes related
number (EIN), permit number and legal name. Do not
to the facility. All permits issued to a deleted facility must
complete any of the other information requested in this
be returned to the Tax Division. Facility game types can be
section unless the information reported on your original
added by checking the appropriate box.
application has changed.
Area-Based Games
Entity Type and Organization Type
Add or delete an area by checking the appropriate box and
Do not complete any information requested in these
completing all information requested in the boxes related
sections unless information originally reported for these
to the area. All permits issued to a deleted area must be
sections was in error or has changed.
Membership
returned to the Tax Division. Area game types can be
Question: You must check the appropriate box.
added by checking the appropriate box.
Members in Charge of Games
Manager of Games
Your organization can have only one primary member
To delete a manager, check the delete box and list the
in charge. If the designated primary member in charge
manager’s first name, middle initial, last name and social
resigns or is no longer able to serve as member in
security number. Then enter the effective date of this
charge, the organization has six months to replace the
action in the appropriate box. To add a manager, check
member in charge. You must report the designation of
the add box and complete all information requested in the
the new member in charge by checking the add box and
boxes under this section of the amended application form.
completing all information requested in the boxes related
A new manager who has not previously taken and passed
to the primary member in charge.
the permittee test must take the 2013 version of the test
and submit a 2013 test answer sheet with the amended
Your organization must have one alternate member in
application form.
charge but it can also designate additional alternate
members in charge as it deems necessary. To report the
Change of Vendor
addition of an alternate member in charge, check the add
Add or delete a vendor by checking the appropriate box and
box and complete all information requested in the boxes
by completing all information requested for each vendor
related to the alternate member in charge. If designating
you add or delete. For each vendor added you must submit
more than one alternate member in charge, attach
a completed 2013 Vendor Registration form and pay the
additional sheets as necessary.
$50 registration fee. You can pay the fee online using the
Online Tax Information System (OTIS) at
If a designated alternate member in charge is no longer
gov or make a check payable to the State of Alaska. If you
able to serve as member in charge, check the delete box
delete a vendor, you must return that vendor’s permit to the
and report all information requested in the boxes related to
Tax Division.
the alternate member in charge.
Change of Operator
New primary and alternate members in charge who have
Add or delete an operator by checking the appropriate
not previously taken and passed the permittee test must
box and completing the requested information. If you are
take the 2013 version of the test and submit a 2013 test
adding an operator you must attach a signed operator
answer sheet with the amended application form.
contract.
0405-826Ai Rev 09/12 - page 1
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