Minnesota Gambling Control Board
1711 West County Road B, Suite 300 South
Roseville, Minnesota  55113
651-639-4000

 The five forms of lawful gambling are
raffles, bingo, pull-tabs, tipboards, and paddlewheels.

Forms for Licensed Organizations.

To return to the Minnesota Gambling Control Board home page, click here.

Forms on this site require Adobe Acrobat Reader 7.0.5.
Click on the Get Acrobat Reader icon to download a free copy. Get Acrobat Reader image 

QUICK LINKS

For all forms sorted by form number, click here.

Organization License       Gambling Manager License       Premises Permits    Off-site Permit

Reporting Changes in Application Information

Board Request Forms

Organization License and Related Forms

Adobe Acrobat PDF  LG200A New Organization License Application. 

Adobe Acrobat PDF  LG200B Organization Officers Affidavit. 

Adobe Acrobat PDF  LG200C 501(c)(3) organization and 501(c)(4) festival organization.     LG200C Information.

 Adobe Acrobat PDF  LG209 Registration/Termination of Paid Gambling Employee. 
 

Gambling Manager License

Adobe Acrobat PDF  LG212 Gambling Manager Application. 

Adobe Acrobat PDF  LG209 Registration/Termination of Paid Gambling Employee. 
 
Premises Permits, Lease, and Rent Worksheet

Adobe Acrobat PDF LG214  Premises Permit Application.

Before the Gambling Control Board can issue a premises permit, the local unit of government where the premises is located (city or county) must give prior approval of the application.

 

To give prior approval, the local unit of government must:
1.  sign the application,
2.  record the date the application was approved by resolution, and
3.  record the resolution number.
The approval must be within 90 days of the date the application is received by the Gambling Control Board.

Adobe Acrobat PDF  LG215 Lease for Lawful Gambling Activity.

Adobe Acrobat PDF  LG216 Worksheet for Calculating Lawful Gambling Monthly Rent.

 

Off-Site Permit
Adobe Acrobat PDF  LG230 Application to Conduct Off-Site Gambling.  
                (NOTE:  This form is not used by exempt or excluded organizations.)
 
Reporting Changes in Application Information to the Board

Adobe Acrobat PDF LG1015 Reporting Organization Information Changes.

Adobe Acrobat PDF LG1016 Reporting Gambling Manager Information Changes.

Adobe Acrobat PDF LG1017 Reporting Premises Permit Changes.

 

Board Request Forms
The following forms are used to request prior approval of the Gambling Control Board for expenditures as required by statute or rule.  Consideration of the requests is given by the Gambling Control Board at its monthly board meeting.  For additional information, contact your compliance specialist.

Adobe Acrobat PDF  LG204 License Termination Plan. 

Adobe Acrobat PDF  LG250 Fund Loss Request for Profit Carryover Adjustment. 

Adobe Acrobat PDF  LG251 Rule Variance Request.

Adobe Acrobat PDF  LG262 Request to Replace Building Destroyed or Made Uninhabitable by Fire or Other Catastrophic Event.

Adobe Acrobat PDF  LG263 Request to Replace Building Taken or Sold Under Eminent Domain Proceeding.

Adobe Acrobat PDF  LG266 Request for Real Property or Capital Assets Used Exclusively for Lawful Purpose.

Adobe Acrobat PDF <a href= LG268 Request for Replacement Building Meeting ADA Requirements.

Adobe Acrobat PDF <font color= LG269 Request to Exceed Annual Limit for Code A22.

Adobe Acrobat PDF  LG270 Request to Contribute Gambling Funds to Another Licensed Gambling Organization. 

Questions? Contact a specialist at the Gambling Control Board. 

To return to the Minnesota Gambling Control Board home, click here.

test