Form 0405-847 - Operator License Application - 2013 Page 2
Download a blank fillable Form 0405-847 - Operator License Application - 2013 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 0405-847 - Operator License Application - 2013 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2Alaska
847
2013 Operator License Application
License #
Operator Name
Contracted Permittees
List permittees for whom you will conduct gaming activities. If more than 10 permittees, attach a separate sheet.
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Permit #
Name of Organization
Game Type(s)
Managers & Supervisors
Provide the required information for each person who manages or supervises any of the licensed gaming activities as defined in AS 05.15.122. If more
than four managers and supervisors, attach a separate sheet.
Employee First Name
MI
Last Name
Social Security Number
Home Mailing Address
Home Phone Number
City
State
Zip Code
Position Title
Employee First Name
MI
Last Name
Social Security Number
Home Mailing Address
Home Phone Number
City
State
Zip Code
Position Title
Employee First Name
MI
Last Name
Social Security Number
Home Mailing Address
Home Phone Number
City
State
Zip Code
Position Title
Employee First Name
MI
Last Name
Social Security Number
Home Mailing Address
Home Phone Number
City
State
Zip Code
Position Title
847
0405-847 Rev 04/17/13 - page 2
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial