Application for Bingo License
(1)An application for a bingo license or license renewal shall be made on a form prescribed by the Department, shall be signed by a responsible official of the organization and shall be accompanied by the license application fee as provided in section (3) of this rule. The Department shall reject applications which are incomplete, are not accompanied by the documents required by this section or are not accompanied by a sufficient license fee. An applicant shall be immediately notified of any such deficiencies. The license application shall include the following information:
(a)The name, address and telephone number of the organization;
(b)A statement of the purposes for which the money received from the bingo games will be used;
(c)A statement as to whether or not the organization has had a license to operate bingo or raffle games denied, revoked or suspended by the State of Oregon or any other licensing authority;
(d)The full names and addresses of the responsible officials of the organization;
(e)For Class A or B bingo licensees, the name and address of the individual proposed by the applicant to act as its supervising bingo game manager;
(f)The address of the location proposed by the applicant where the bingo games will be held; the amount of rent to be paid for the location if not owned by the applicant; the party who is to be paid rent, if any; and a statement that rent will not be paid to a related party;
(g)The class of license sought by the applicant; and
(h)For Class A or B bingo licensees, the name and address of the financial institution and the account number for the bingo account(s) to be used by the applicant.
(2)The applicant shall submit the following documents with the application. The information required in subsections (c) through (f) of this section shall be on forms prescribed by the Department:
(a)A copy of a letter supporting tax exempt status as specified in OAR 137-025-0030 (Eligibility for Licenses in General)(c);
(b)For a Class A or B license, a copy of a current or proposed lease agreement for the location of the bingo games if the applicant does not own the premises intended for use;
(c)For a Class A or B bingo license, a completed authorization to inspect bank records on a form furnished by the Department, authorizing the financial institution to disclose customer information regarding the applicant’s bingo account to the Department;
(d)As required by Chapter 914, Oregon Law 1987, a waiver of potential liability claims against the State of Oregon, its agencies, employees and agents for any damages resulting from any disclosure or publication of any information acquired by the Department during any of its investigations, inquiries or hearings;
(e)A consent to inspections authorized by Chapter 914, Oregon Laws 1987, and the rules adopted thereto;
(f)A statement verifying whether or not the applicant has conducted bingo operations during the 12 months prior to submitting the application for a license and, if so, a financial summary of its operation; and
(g)Such other information as may be requested by the Department.
(3)The application fees are as follows:
(a)Class A license — $200;
(b)Class B license — $100;
(c)Class C license — $40;
(d)Class D license — $20.
Rule 137-025-0060 — Application for Bingo License,