Form 50b - Nebraska Application For Commercial Lessor Of A Bingo Premises Page 3
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3LINE 4. Enter the type of ownership of your business or organization. Partnership includes all types of
partnerships (general, limited, and joint ventures). A domestic corporation is a corporation which is organized
under the laws of Nebraska and is qualified to do business in this state. A foreign corporation is a corporation
which is organized under the laws of another state. A domesticated corporation is a foreign corporation that has
been domesticated in accordance with Nebraska law. A nonprofit organization or corporation is one in which no
part of the income is distributed to its members, directors, or officers.
LINE 7. Out-of-state applicants, which are not corporations or limited liability companies, must designate an
individual at least 19 years of age who is a resident of, and living in, Nebraska as a resident agent for the applicant
in Nebraska.
LINE 9. Identify any individuals not listed in section 8 which have an ownership interest in the business named
in the application. “Ownership interest” means a right to share in the profits, losses, or liabilities of the business
and includes loan guarantors who make actual debt payments for or contribute capital to an operation with a
contingent right to share in the profits, losses, or liabilities of the operation. Do not include any stockholder
holding less than 10% of the stock of the corporation. Also, do not include any financial institution organized or
chartered under the laws of Nebraska, any other state, or the United States relating to banks, savings institutions,
trust companies, savings and loan associations, credit unions, installment loan licensees, or similar associations
organized under the laws of Nebraska and subject to supervision by the Department of Banking and Finance.
LINE 10. If you are not the owner of the premises, identify the full name, address, Social Security number, date
of birth, type of involvement, and the percentage of ownership of each person having an ownership interest in
the premises. A commercial lessor, the owner of a premises, and all parties who lease or sublease a premises
which is ultimately leased to a licensed organization for the conduct of bingo, cannot be involved directly with
the conduct of any bingo occasion subject to regulation, including, but not limited to, the managing, operating,
promoting, advertising, or administering of bingo. These persons may not derive any financial gain except those
amounts authorized for: (1) a licensed pickle card operator pursuant to the
Nebraska Pickle Card Lottery
Act;
(2) a licensed lottery operator or sales outlet location licensed pursuant to the
Nebraska County and City Lottery
Act; or (3) a contracted lottery game retailer pursuant to the
State Lottery Act.
AUTHORIZED SIGNATURES. Form 50B must be signed by an owner, partner, officer, or member listed in
section 8, or a person authorized by an attached
power of
attorney.
Any questions regarding the completion of Form 50B may be addressed to the Nebraska Department
of Revenue, Charitable Gaming Division, PO Box 94855, Lincoln, NE 68509-4855, or telephone
402-471-5937 or 877-564-1315. Additional information and forms may be obtained from the Department’s website
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