Instructions For 2013 Alaska New Permittee Check List Page 2
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2Instructions for 2013 Alaska New
Permittee Check List
An applicant for a permit that is not a municipality shall
DEDICATION OF NET PROCEEDS
accomplish the notice required under AS 05.15.030(a) by
Describe in detail how the organization intends to use
submitting one copy of the application submitted under (a)
the net proceeds from gaming activities. See statutes
(1) or (b)(1) of this section to the city or borough nearest
and regulations. Planned uses must be consistent with
to the location in which the applicant seeks to conduct an
AS 05.15.150 and 15 AAC 160.810. This section must
activity permitted under AS 05.15.
be completed.
Mandatory Attachments:
Please allow 3 to 4 weeks for your application to
Enclose a current Alaska membership list. This list
be processed.
must contain at least 25 persons but please limit to not
more than 40.
Test answer sheet, if applicable, for Primary or Alternate
Where to send Form 826
Member in Charge or Manager of Games.
TAX DIVISION - GAMING UNIT
ALASKA DEPARTMENT OF REVENUE
One piece of documentation for each of the last four
PO BOX 110420
years, showing the organization’s ongoing existence.
JUNEAU AK 99811-0420
Examples are bank statements or minutes of board
meetings dated: 2009, 2010, 2011, & 2012.
Certified copy of Articles of Incorporation and a copy
of the By-Laws. By-laws must contain a dissolution
clause that provides for the disposition of net proceeds
from charitable gaming activities.
See 15 AAC
160.020(a)(5).
IRS tax exempt status letter, if applicable.
Not
applicable for municipalities.
Signature card for separate gaming checking account
(must have two signatures), and a voided copy of a
gaming account check showing two signature lines.
The bank account must include the word “gaming” in
the name or title that appears on checks and bank
statements.
If applying for a Special Draw Raffle permit, a detailed
description of how the special draw will be conducted.
If applying for a Calcutta Pool permit, a statement
providing the date and physical location of the auction
and the date and physical location of the event. A
separate permit is required for each Calcutta pool
conducted.
Signed Operator Contract. (Only if an operator is going
to conduct gaming for your organization.)
0405-826i - Rev 09/12 • Page 2
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