How to complete the State of Nevada Gaming Control Board,
Charitable Lotteries Application for Approval or Registration
(revised 4/29/08)
Attached is an example of the Charitable Lotteries, Application for Approval or Registration form. If you have received a packet, you can utilize the blank form provided. If you would like a blank form via the web, please visit http://gaming.nv.gov/forms/frm033.pdf.
Listed below is information to explain the process. Information in blue should remain the same every time your group completes an application. Information in red will be provided by your group, depending on the specific lottery.
Once you have completed the application, send the original to the address provided on page 4 of the application. Please send a copy of the completed application to: University of Nevada, Development and Alumni Relations, Mail Stop 0162, Reno, NV 89557-0162.
PAGE 1
Organization Name: University of Nevada, Reno
Street Address: Mail Stop 0124
City, County, Zip Code: Reno, Washoe 89557-0124
Nature (Type) of Organization: Non-profit/higher education
When Organization was established: 1874
Contact Person: Name of individual representing the group that is applying.
Telephone: Phone number of the individual representing the group that is applying.
Signature: Signed by the individual representing the group that is applying.
Date: Provide the date signed.
Is this an application for registration or approval for a charitable lottery?
Always is Request for Approval.
PAGE 2
Officers/Board of Directors: NSHE Board of Regents
Title: NA
Telephone: 775-784-4958
Persons responsible for operation of the lottery and their relationship to the organization.
Name: Name of individual representing the group that is applying along with name of the group.
Relationship to Organization: Insert the relationship of the person representing the group and the group’s relationship to UNR. (ie: President, Young Alumni Chapter)
Telephone: Contact information of the person representing the group.
Description and value of lottery prizes in this calendar year:
Various lotteries held each year.
If this is a request for approval, what are the anticipated expenses of conducting the lotteries during this calendar year…?
Include any costs that you will incur to conduct the lottery. For small lotteries, this may only be the cost of raffle tickets. Other costs could include hiring an auditor or a mailer to advertise the lottery.
Describe the intended use of net proceeds from your charitable lotteries…
Describe the use – scholarships, operating funds, etc.
PAGE 3
Name of the primary county in which the lotteries will be conducted: Washoe (chapters operating within Nevada, but outside of Washoe County – ie: Fallon Chapter – will be exceptions)
Date Ticket Sales BeginDate, Time, & Place of Drawing
Complete for your event.
PAGE 4
Please attach the following documents:
Proof of charitable or nonprofit status.
Nonrefundable fee in the form of a check or money order – provided by your group – made payable to the State Gaming Control Board for $25.
If you are requesting approval, copies of proposed agreements with suppliers of material for the operation of your lottery. This is back-up for information provided on Page 2. If you have no expenses other than the cost of raffle tickets, then you do not need a memo. If you have other expenses, then include that in the memo.