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Official Minnesota Lg220 Form in PDF

The Minnesota LG220 form is an application for an exempt permit, designed for nonprofit organizations that wish to conduct lawful gambling on five or fewer days each year. To qualify, these organizations must award less than $50,000 in prizes during the calendar year. If your organization meets these criteria, consider filling out the form by clicking the button below.

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The Minnesota LG220 form serves as an essential application for nonprofit organizations seeking to conduct lawful gambling events under specific conditions. Designed for groups that operate on a limited basis, this form allows organizations to apply for an exempt permit if they plan to hold gambling activities for five days or fewer within a calendar year and award total prizes of less than $50,000. The application process requires organizations to provide detailed information, including proof of nonprofit status, which can be demonstrated through various documents such as Articles of Incorporation or IRS exemption letters. Additionally, organizations must specify the location of their gambling events and the types of activities they intend to offer, such as raffles, bingo, or pull-tabs. Local government acknowledgment is also a critical component, ensuring that the proposed gambling activities comply with municipal regulations. By adhering to these guidelines, nonprofits can successfully navigate the application process and contribute to their fundraising efforts while remaining compliant with Minnesota's gambling laws.

Form Example

MINNESOTA LAWFUL GAMBLING									1/13 Page 1 of 2
LG220 Application for Exempt Permit

An exempt permit may be issued to a nonprofit organization that:							Application fee (non refundable)
- conducts lawful gambling on five or fewer days, and
- awards less than $50,000 in prizes during a calendar year.							If application is postmarked or received 30 days or
If total p ize alue fo	the yea	ill e $	,5 o less, o ta	t the li e si	g		If application is postmarked or received 30 days or
If total p ize alue fo	the yea	ill e $	,5 o less, o ta	t the li e si	g		more before the event $50; otherwise $100.
spe ialist assig ed to you ou		ty.					more before the event $50; otherwise $100.
spe ialist assig ed to you ou		ty.

ORGANIZATION INFORMATION

Organization name							Previous gambling permit number

Minnesota tax ID number, if any			Federal employer ID number (FEIN), if any

Type of nonprofit organization. Check one.
_____ Fraternal	_____Religious		_____Veterans	_____Other nonprofit organization

Mailing address			City			State		Zip code	County

Name of chief executive officer [CEO]			Daytime phone number					E-mail address

NONPROFIT STATUS

Attach a copy of ONE of the following for proof of nonprofit status.

_____ Nonprofit Articles of Incorporation OR a current Certificate of Good Standing.

Don’t have a copy? This certificate must be obtained each year from:

Secretary of State, Business Services Div., 60 Empire Drive, Suite 100, St. Paul, MN 55103

Phone: 651-296-2803

_____ IRS income tax exemption [501(c)] letter in your organization’s name.

Don’t have a copy? To obtain a copy of your federal income tax exempt letter, have an organization officer contact the IRS at 877-829-5500.

_____ IRS - Affiliate of national, statewide, or international parent nonprofit organization [charter]

If your organization falls under a parent organization, attach copies of both of the following:

a. IRS letter showing your parent organization is a nonprofit 501(c) organization with a group ruling, and b. the charter or letter from your parent organization recognizing your organization as a subordinate.

GAMBLING PREMISES INFORMATION

Name of premises where the gambling event will be conducted. For raffles, list the site where the drawing will take place.

Address [do not use PO box]						City or township			Zip code		County

Date[s] of activity. For raffles, indicate the date of the drawing.

Check each type of gambling activity that your organization will conduct.
	_____	Bingo*	_____	Raffle	_____	Paddlewheels*	_____	Pull-tabs*		_____	Tipboards*

*Gambling equipment for bingo paper, paddlewheels, pull-tabs, and tipboards must be obtained from a distributor licensed by the Minnesota Gambling Control Board. EXCEPTION: Bingo hard cards and bingo number selection devices may be borrowed from another organization authorized to conduct bingo.

To find a licensed distributor, go to www.gcb.state.mn.us and click on Distributors under the WHO’S WHO? LIST OF LICENSEES, or call 651-639-4000.

LG220 Application for Exempt Permit

LOCAL UNIT OF GOVERNMENT ACKNOWLEDGMENT

1/13 Page 2 of 2

CITY APPROVAL for a gambling premises located within city limits

___The application is acknowledged with no waiting period.

___The application is acknowledged with a 30 day waiting period, and allows the Board to issue a permit after 30 days [60 days for a 1st class city].

___The application is denied.

Print city name _______________________________

Signature of city personnel

___________________________________________________

Title ____________________________ Date______________

Local unit of government must sign

COUNTY APPROVAL

for a gambling premises

located in a township

____The application is acknowledged with no waiting period.

____The application is acknowledged with a 30 day waiting

period, and allows the Board to issue a permit after 30 days.

____The application is denied.

Print county name _______________________________

Signature of county personnel

___________________________________________________

Title ____________________________ Date______________

TOWNSHIP. If required by the county.

On behalf of the township, I acknowledge that the organization is applying for exempted gambling activity within the township limits.

[A township has no statutory authority to approve or deny an application, per Minnesota Statutes 349.166.]

Print township name ________________________________

Signature of township officer __________________________

Title ___________________________ Date _____________

CHIEF EXECUTIVE OFFICER’S SIGNATURE

The information provided in this application is complete and accurate to the best of my knowledge. I acknowledge that the financial report will be completed and returned to the Board within 30 days of the event date.

Chief executive officer's signature___________________________________________ Date______________

Print name ________________________________

REQUIREMENTS

Complete a separate application for:

all gambling conducted on two or more consecutive days, or

all gambling conducted on one day.

Only one application is required if one or more raffle drawings are conducted on the same day

Send application with:

__ a copy of your proof of nonprofit status, and

__ application fee (non refundable). Make check payable to "State of Minnesota."

To: Gambling Control Board

1711 West County Road B, Suite 300 South

Roseville, MN 55113

Financial report and recordkeeping required

A financial report form and instructions will be sent with your permit, or use the online fill-in form available at www.gcb.state.mn.us.

Within 30 days of the event date, complete and return the financial report form to the Gambling Control Board.

Questions?

Call the Licensing Section of the Gambling Control Board at 651-639-4000.

This fo	ill e ade a aila le i alte ai e fo at i.e. la ge p i t, B aille
upo e	uest.

Data privacy notice: The information requested on this

form (and any attachments) will be used by the Gambling

Control Board (Board) to determine your organization’s qualifications to be involved in lawful gambling activities in Minnesota. Your organization has the right to refuse to supply the information; however, if your organization

refuses to supply this information, the Board may not be able to determine your organization’s qualifications and,

as a consequence, may refuse to issue a permit. If your

organization supplies the information requested, the Board will be able to process the application. Your organization’s

name and address will be public information when received by the Board.

All other information provided will be pri- vate data about your organization until the Board issues the permit. When the Board issues the permit, all information provided will become public. If the Board does not issue a permit, all information provided

remains private, with the exception of your organization’s name and address which will

remain public. Private data about your organization are available to: Board mem- bers, Board staff whose work requires

access to the information; Minnesota’s

Department of Public Safety; Attorney

General; Commissioners of Administration, Minnesota Management & Budget, and Revenue; Legislative Auditor, national and international gambling regulatory agencies; anyone pursuant to court order; other indi- viduals and agencies specifically authorized by state or federal law to have access to the information; individuals and agencies for which law or legal order authorizes a new use or sharing of information after this notice was given; and anyone with your written consent.

➤ Minnesota Lg220 File

Form Specifications

Fact Name	Details
Purpose	The LG220 form is used by nonprofit organizations in Minnesota to apply for an exempt gambling permit.
Eligibility Criteria	Organizations must conduct gambling on five or fewer days and award less than $50,000 in prizes annually.
Application Fee	The non-refundable application fee is $50 if the total prize value is $50,000 or less; otherwise, it is $100.
Nonprofit Proof	Applicants must attach proof of nonprofit status, such as Articles of Incorporation or an IRS 501(c) letter.
Governing Laws	This form is governed by Minnesota Statutes 349.166, which outlines regulations for lawful gambling.
Local Approval	City or county approval is required, with options for acknowledgment and waiting periods specified in the application.
Reporting Requirement	A financial report must be submitted to the Gambling Control Board within 30 days following the event.

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