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90-691 0 R�I G I N i� � , Council File # _ o—�p�� Green Sheet ,� 5865 RESOLUTION �- CITY OF S T PAUL, MINNESOTA � �� ; �_, .:: Presented By Referred To Committee: Date RESOLVED: That application (ID ��55004) for renewal of a Class B Gambling License by Attucks Brooks American Legion Post 4�606, 976 Concordia, be and the same is hereby approved/�ec�-. as Navs Absent Requested by Department of: inr n o w z � on �— � cc ee '�— e man "� u e —� i son � By: �— Adopted by Council: Date APR 2 4 1990 Form Approved by City Attorney Adoption Ce tified by Council Secretary gy: ` �-!�`9Q By� Approved by Mayor for Submission to Approved by Mayor: Date APR 2 5 1990 counci� By: ��� By s PU�IISHED MAY - 5 1990 � � � - T ��a —�'� DEPARTM[NT/OFFICEICOUNCIL DATE INITIATED � Finance/License GREEN SHEET NO. ����a� CONTACT PERSON 8 PNONE �DEPARTMENT DIRECTOR GTY OOUNCIL Christine Rozek-298-5056 ��� UI cm nTror�ev g CITY CLERK MUST BE ON COUNCIL AOENDA BY(D11T� AOUTING �BUDOET DIRECTOR �FIN.8 MOT.BERVICEB QIR. 4-24-9� �MAYOR(OR ASSISTAN'p � Council R TOTAL�►OF 81ONATURE PAGiE8 (CLIP ALL LOCATION8 FWi SIGNATUi� . ACT10N REGUESTED: Approval of an application for renewal of a State Class B Gambling License. Hearing Date: 4-24-90 Notification Date: RECOMMENDA :ApprtHS(A)a R�x(R) (�, �pQpT Qp�'�, _PIANNINO COMMNBSION _(�VIL SERVIC�COMMI8810N ANALYST PNONE I�q. _G8 COMMITTEE — _STAFF _ COMMENTS: _DISTAICT OOURT _ SUPPORT8 WHICM CWNGL OBJECTIVE9 INITIATII�(i PHOBLEM.ISBUE.OPPORTUNMTY(WAo�M�ha�Whsn��Nhsro�M�hy). Harry D. S. Thomas, Sr. on behalf of Attucks Brooks American Legion Post �606 requests Council approval of the renewal of a State Class B Gambling License at , 976 Concordia. Proceeds from the pulltab sales are used for various charitable purposes. Al1 fees and applications have been submitted. License fee of $373.25 has been submitted. . ADVANTAOES IF APPROVED: If Council approval is given, Attucks Brooks American Legion Post ��'606 at 976 Concordia will continue pulltab sales at =its club. OISADYANT/UiEB�F APPROVED: DIBADVANTAOES IF NOT APPROVED: RECEIVED �GUncu Kesearch (:enter. ARR�.2�� APR 3. ��990 CITY CLERK - TOTAL AMOUNT OF TRANSACTION = t�BT/REYENUE WD�TED(CNICLE ON� YES NO F1N�Dpi�i SOURCE ACTIVITY NUMlER flNANCIAL INPORMATION:(EXPLAIN) � d� . , , - ��a --��'� DIVISION OF LICENSE AND PERMIT A.DMINISTRATION DATE J J �U / 3 � �� INTERDF.PARTMEfiTAL REVIEW CHECKLIST Appn roc ssed/Received by Lic Enf Aud �tCc v v� �, S.`"I�t o mli S S r^ Applicant �kS �r�;��5�-vr� L2��c�� Home Address , �° ��- � y� - �ao5 Rusiness Ivame Home Phone Business Address �1�.e �nC�✓C�t�v Type of License(s) C(k55 � � Business Phone LTGt rn �)i n C.� c�-rSe �✓�uJ� � Public Hearing Date "`�" oZ � �� License I.D. �{ � `J b0 � at 9:00 a.m. in the Council Chambers, 3rd floor City Hall and Courthouse State Tax I.D. �� lU'�' llate l�otice Sent; Dealer 4� �I/4' to Applicant ��� rederal Firearms �6 Pub.lic He�.�ring DATE IrSPECTIUN REVIEW VERFIED (COMPUTER) CUMMENTS A roved Not A roved � Bldg I & D � � l� � Health Divn. -- ' ��a ' , Fire Dept. � � ; �'�4 I Police Dept. I �� � � � ��I � . �I cl(�' License Divn. � I I, City Attorney � �(l� �� ' o��. Date Received: Site Plan ��� To Council P.esearch �� �� �� Lease or Letter Date from Landlord ���r CURRENT INFORMATION NEW INFORMATION Current Corporation Name: New Corporation Name: Current DBA: New DBA: Currer.t Officers: Insurance: Boud: - �v'orkers Compensation: New Officers: Stockholders: N � �. City of Saint Paul Ci�— l��g� ' ' Department of Finance aad Management Services Division of Licease and Permit Registration INFORMATION REQIIIRID WITH APPLICATION FOR PERMIT TO SELL PULLTABS � TIPBOARDS IN SAINT PAUL (Class B Gambling License in Liquor Establishments - Renew) . 1. Full and complete name of organization which is applying for license ����if.G��7?��v�fbA �I/YNIJ3GCa.,�. �.u,.u.,,✓ �rG� � �o� 2. Address where games will be held �710 � AT.�.�,wQ S�/d'� Number Street City Zip 3. Name of manager signing this application who will conduct, operate and manage Gambling Games �� J.S. THO/y1�5 SR Date of Birth �f��j��g , (a) Length of time manager has been member of applicant organization �(� ��qg 4. Address of Manager ��y/ ���„� �. �„w�,Q S-��//7' Number Street City Zip 5. Is the applicant or organization organized under the laws of the State of MN? y,e S T— 6. Date of incorporation /q�� 7. How long has organization been in existence? / 9� y 8. How long has organization been in existence in St. Paul? �c��L� 9. What is the purpose of the organization? '►/,���� � _�,�,�J 10. Officers of applicant organization: Name �.e.o-n h)e�-�.d( Name � rme�,Q,eQ �Qu�,G,dL�,� Address f��l rL�1U4,G►m,,,,� ,5,��.u,,�, iri,,1 ,SS�o l Address $'7/ ,�• .y�,�, �.l�A�,l Ss�e4[ Title � „� DOB !, Title � � DOB /,9 � �— Name ��,,�� ,wi�,,,,, Name � Address �cj/ ,MT �/;g,�'/a,�/ Address Title ` DOB �. Title DOB 11. Give names of officers, or any other persons who paid for services to the orgaaization. /}lp N e Name Name Address Address Title Title (Attach separate sheet for additional names.) . : . . ��o_�y� 12'. Attached hereto is a list of names and addresses of all members of the organization. 13. In whose custody will organization's pulltab records be kept? Name� law ..,,lo.�y,��� ;.,,, �l��e6 Address 97G � �•��. /yj�/ 14. List all persons with the authority to sign checks for dispersal of gambling proceeds: Name Name Address /G ' i Address Member of Member of DOB Organization? �c„�,S_ DOB Organization? T-- Name �..�� ��Q� Name Address / �Z,c,lS"��,,,,,.e„� ,a,�(t��_A►,d�s'io/ Address —T Member of Member of DOB Organization? � DOB Organization? 15. Have you read and do you thoroughly understand the provisions of all laws, ordinances, and regulations governing the operation of Charitable Gambling games? � 16. Attached hereto on the form furnished by the city of Saint Paul is a Financial Report which itiemizes all receipts, expenses, and disbursements of the applicant organiza- tion, as well as all organizations who have received funds for the preceding calendar year which has been signed, prepared, and verified bq _ - � ���f� V� � . �• �.�,�,�, m� s�s��i� Address who is the � �,r.e,u.e_.._ of the applicant organization. Name 17. Will your organization's pulltab operation be operated/managed solely by members of your organization? yes �/ no 18. Has your organization signed, or does it intend to sign, a consultiag agreement or a managerial agreement with any person or company to assist your organization with the pulltab sales and/or recording keeping? yes no � If answer is qes, give the name and address of the person and/or company contracted. Name Address Name Address If answer is yes, how will such a consultant be paid? (percentage, flat fee, gambling funds, general funds, etc.) Attach a copy of said contract to this application. 19. Operator of premises where games will be held: Name �,C.GC,u'� /°�..s�� �n.c,��..����i�f�� ��PO� Business Address Cj 7� �ry��n,�� o�/ �u,Q, }YJi✓ v��/P�f__ � Home Address : �. . . . . (l�r ya_�9� 20. a) Does your organization pay or intend to paq accounting fees out of gambling funds? yes �/ no b) If you do pay accounting fees, to whom will such fees be paid? Name p���dyr,,o�,d 7"� �.t�.�nc.t_ Address /�a y/ l�uu�r.n,r.�, ,�. ,�'i.licu,p/1'jN SS//� DOB Member of Organization? y�s � c) How are the accounting fees charged out? (flat fee, hourly, etc.) �o�l/� d) What do you anticipate will be your average monthly deduction for accounting fees? '�/so-a o0 21. Amount of rent paid by applicant organization for rent of the pulltab sales area: _ il/O N e 22. The proceeds of the games will be disbursed after deducting prize layout costs and operating expenses for the following purposes and uses: . . 23. Has your organization filed federal form 990-T? G��S If answer is yes, please attach a copy with this applicatioa. If answer is no, �xplain why: Any changes desired by the applicant association maq be made only with the consent of the City Council. a � � #�� • rganization Name Date �.?,(e I�� By: ager i charge of game k�/ . �o[� . Organization President or CEO � City ot Saiat Paul Page l Departasnt of Tinanee and lSana;sment Servicea ( � ' Diviaion of Lieense and Pet'!.t Adsiaistsation � GO-�� � UNIP'aRli CHARITADLE CAMDLINC FINANCIAL REPORT Dat• L. Naea of Ortanisation ��� �'!�►��_.d w.�.^ •�,.�'►, �i"4/� '��006 2. Addr�s• vhere Charitabl� Caablint is coeduetad 9 rd �er,n.��e.�ii �t��u,cli,�N 3. Rspore tor period covarin� i�� 19�_ Chroufh /�d/ 19� 4. Total number of days play�d /B� S. Cro�a reeeip�s for abov� p�riod = /d�� y/Q' 6. Gross prizs pa�outs for abov p�riod (iaelud� eash short) � g�i S'�7 7. Nat t�esipes - lia� S sinu� lin� 6 f - it0�„f h�/ 8. Expsnses incusred in eonductin� and op�rstint �a�: A. Ccos� va�ss paid. Attseh vorkst liit vith nam�s, address�s. �to�s va��s. numb�r of hwrs S NeN� vorksd. and asouat paid p�r hovs. B. Reat for vesks S r✓eN� C. License fee ; �s�•�y� D. Insuranee f ,uduc E. Bond f /it 5.00 !. Dishonoted eh�cks not recovered i No N� C. Aeeounein� Expsas� i ,,(t77S.oD H. Employsr� T.I.C.A. t NoNL I. Pullcab Ta�c Paid to D�parwnc of ll��snu� � ���'9•/G J. Minn. U.C. tax = ��'�� R, iedaral Lxeiss !a: i Statp ; 7G�' �Z L. Stat• Ga�blin� '!u s M. Mi�csllawou� Exp�aas�• Id�ntit� tM a�aint aad to rbn psid. 1.Uf�l��-r'es t �oOQ•00 z.�� J�is , c sid �gw p a o•oo 3.T��/�� G n� _ �/ /G �. Ca,�,�.,«l I�aGw = �7a.o0 9. 'loeal Ta�Psnw ToT�►L f /0;S�e4.�5' 10. t1�t IoeoN - lia� 7 d�• lin� 9 3 �,5'7'�.75� ' 11. Ch�ckbook balanee b��imin� of p�riod i 3+ �5 G•O D 12. Total of lise 10 and ti i ��/.�73� " � 13. Total eontsibutions (fsoi actuh�d vocbh�st) ; �(e7�• S'G 16. Ch�ckbook balane• end ot rsportiat p�riod - � �,�J 9a •a•� liae I2 le�s lin� 13 — ('lV(JL— ., vr� � v� .�� . rnV�. � ' , • � UNIFORM CHARITASIE GAMBLING FINANCIAL REPORT LAWFUL PURPaSE CONTRI BUTIONS - WORKSHEFT ��Q-jp�f/ Line #13 - Total Lawful Pu � rpose Contri buti ons. 3 �/ 7�', 5� List below ail checks written from gambling funds which are charitable lawful purpose contributions. The total doilar � art�unts of these checfcs must match the amount claimed in line #13. Use additional sheets as necessary. CHECK � OATE � PAYEE CHECK AMOUN PURPOSE . 1. /lp o�- �/s/g 9 Oh� P.�t,e s� �r``3.�5/t9' 7,�,,�.��r��,���,l�.c.lqo�- o2I9I89 H�°��'�'0�`°""��Ri� (PO0•�0 /3l��e� 7�� �jp i�' 2. ��v�� � � �� �la�r/8 9 ��,�e � m�u� /a��d D �.� 3. /G a� ��.�.�.� /�a a .�j���8y iwti►, �j C��M:�^�'►e��".� iaa.da ��y"��,.� 4. � ? oo rt' 9�� 3/a���i {�n�?�u.e�- C.��-'�- `ve�� �DO� d I 5. 1Ga� , / � �-��"�`�"'"� �P�'•do ��� f�a"r' ��� . ���3�85 �cu�i�? 6. /�a 9 70.00 � S�w� .�l30%9 r�c fY . 7. �( 3� tiw G��"'`r� �u-e.' �Q�p ���.►,� `�'�U° '��1 s. /G 3 7 y/�6/� . . �����,� �� � ,�,�r ���- aoo.o� -13� � /�-�° g, �/39 � . 6 �l���i �e� -�.c'+�'� '��� �8 0•�a �a� ✓�Jt�o-�a�m� 10. /6'� . ����a�.-vru� ��''',�'�y`' 3/���9 �'�'�a � �0•o0 11. ���f? , � ��,l'_..__ ,�,�. C,w,eT',,,., /Sp.o 0 12. /��g 5��'�B�S �r. �"�"" ��� ��� 13. rl��9 s/��.1 s5 ..��.a� ���� 70•oo 70TAL CHECK AMqUNT S aS6�•�f0 NOTE: These expend�tures will be provided to Council Members at your Council hearing. -� Be sure that your financial report is complete and accurate. r � � � � � � � r � � � ! � w +� � � � f : • � • : .. .. w ` . I : � { � ` ♦_ s _ � I 3 � � � = s � � � = e� w � S � �♦ s � � � � � � � ? ! 2 � '� � � T a � " � s � � � n • " • �. w � � � t « � a � � � PI M ! � 'J 1! � ; � : � � � � = s � � > 3� w i • � �t � Z A • � ( � 1 , + O � � •� Y.�t � • A � � • _ � r1.r�/ 7� : • '� ` .r•rv • A • i ! . � i� � s ! � • s � • � ;� ` �_ • � .� w + � •� � • �e.y < �O< � 7 � � � '� i � � w � � ° � � � s M � � r ` � i ` ' I • ' A ' • ' ! w ; � _ �� 4 VW11�lWIIY! � � J � • 0 � � ? t .. � • 1 1 '�"� ' i =� �C � s i1 � � � � s I 1 i ` f va� � V� ,� . rnVL " - . UNIFORM CHARITABIE GAMBLING FINANCIAL REPORT LA1dFUL PURPOSE CONTRI6UTIONS - WORKSHEET �"y0-�y� � , Li ne #13 - Total Lawful Purpose Contri buti ons. 3 �_G 7�• S"6 List below all checks written from gambling funds which are charitable lawful purpose contributions. The total dollar arr�unts of these checks must match the amount claimed in line #13. Use additional sheets as necessary. CNECK � DATE ' PAYEE CNECK AMOUN PURPOSE 1. /4s'/ S1�.�89 (�rra^�- ,�`",Br�° A� .to.00 ��� �.�1ir1�i4y�� i_ � �4� 71 p,oo • �L�G. � �y/�-y��y ���,n ��p.� ��� G'�° 2. 6�� � �oa' /oo•o0 3. [b�-y 4 isl 89 �''�'�'.�`°�, . . D�� �p�9/ �� �l""'"'��� '��� /liOD•o0 1 """" 4. /�(v a �o.oa .G /q��9 �"�` �'`'�"J � ���.��� 5. /�G 3 ���� �loo.00 6. i��� .�/�,ls�y �� m�`«a` �`�`'u`t . 7. � �9 �/,ql�y ��.►-d,►�� �-w"�„,�- ��o,00 ���� . � �,r,,� ,3o m•c o .��`�°,r„..,.`.� s. ��7 � �/,g l�5 � Na^-�- ��'`c�' p oo ���wc�vw� 9. /G��F �/3i�sg ��.�. �,�' � � � �, �i� 7�'����� �l�ws`Ifid/�,''�� �`w`.�'u�� .lv m•0 0 10. lG 76 �.oo .���'��`a° 11. /G y y �5�9��y G���"",'�`° . � ���,,,� /� �o•c�o /i.� -��'''"�".�-'^� . 12. /� 8r �/�¢/89 h C�u� �.O /o•a o c�A��' �•�- 13. I G 8�. �lis'lS 9 •����'��� � TOTAL CHECK AI�UNT � 3yG 6•0 0 -T NOTE: These expenditures will be provided to Council Members at your Council hearing. Be sure that your financial report is canplete and accurate. • r i T � � •� 3 � . _ � � ♦ � y � w �L � � ! w j � � J y � � : .. .. w ` � � + y e � �+� I Y � � •�i � a ` � • O � a s � O � 2 � � � � r � � w � ! � _� . � � � _ � � � � � � a Z � �� : K � ' i � • a w 3 r � � 1 r � . ^ � r {� M + � � .7 y� i �y � � A ; � g � � . � 3 � �S � " � .. � en fRW �''� A � � � � I S � • � � f •'J . �A�{'� + w � � i .�r.r.r •�i 3 A q i ! .r�rv � �� ; '� O : • � � • i � '� � • , �� � • s s ��� � � + .. a O � 2 �' � � �= 1 � + s • - • • ' • � ' I '� ` � I a n i � � �•' ' � � � il 'Q ; � �? I pIM{��d t wl � ` � ( • ( ~a � i r ` � i� � f i G1 � i 1 � � I � � ' � � ( T � � �►a� � vi .�� . r nv i.. � . . . UNIFORM CHARITABLE GAMBLING FINANCIAI REPORT LAWfUL PURPOSE CONTRI6UTIONS - WORKSHEET '� ����� . . . . . . . � ' f Li ne #13. - Total Lawful Purpose Contri buti ons. 3_�( 7�, s 6 List below all checks written fran qambling funds which are charitable ]awful purpose contributions. The total dollar � amounts of these checks must match the artrount claimed in , line #13. Use additionaj sheets as necessary. CHECK # DATE � PAYEE CHECK AMOUN PURPOSE 1. /mg3 �/��$S �°!9�«�a R� �"'� '� ?m0•oo �t.?� ' 3.50�oo �it!��c.t,�%►<� 2. /!o S� �8'Ig y �''"�- ��uf^^,a.�'`�° �� � / __ �� eZ0�Oa G�u"'t4�''", 3. 1�9D 9/�3��� r,�ew��- a. ��5 3 y/���/gs �•�a�w�4 C/w� �s,00 �a��'— 5. ��y� y/,�l�5 /���� �^^� ��' �o.o o �d�-�--- � �✓ 6. i�95 9/,c/s� � �. �s.00 �'�,� S�- , 7. /!�5 9 �a���lg S r�^�+- 1�-w �'^"' �� 37•s� . c b'7��O� �i�cC'�'�"''`e �`,�.�- 8. �7vo �ol3d�gy /V��'A P � 9. l70� ��/r/a9 �°i.0 ,C3oa-�C� /�--°'°o ��-�°�.`� ��� 10. /70 5 � G,.� �6Z /s,GG �,/�dl�� � 11. � 7o G i���l�s ��al3�•�,��y ��� �:oo,00 ��, � I2. � 7 i� lyl�/�9 �!�'�� �ao -aa ���..� � /0 0-U CJ Gd��",c',..�`�` '�*^"�` 13. /� � � �r���d y �b�� ��X'c�-�"� /'L• �7 i� ��/�,.ol a s �� �� 30 0.a o ��' °� 7 TOTAL CHECK Al�UNT � �.3.�3./G —T NOTE: These expenditures will be provided to Council Members at your Council hearing. Be sure that your financial report is complete and accurate. � �sr . � v i T O � � � � i i w 7� .. w � �� ' • : �. � w � . I + + � � � ~" i I 3 : : � s � : � : = os s ' � r � r w � ! �j S� ' � � f ! 2 � � � i i � w �� � • � � T w � `� � � � • �s�j � � � {�1 M � � � ♦ � �Q ° s �r ( � � � � • • t � w > • � > 1� �. s 1 � i I + � t �. I � 7 '.S A � O A O • + O � � s •7 ycp Z • � � � ! A .�..rv s s . ����r. r � ; ; ��r� � A � ♦ � w 1 ♦ i� i : : � � � � � � `� � � �� � � �� • ! = • e � � �_ � � i s • s ,� i :o � • o w s . � � � � r�� a' � � � � � w � �1r ! :l � i � I � I�. O_U �� . � � � j i O tN � � I ��NVNWrW� � I ; , "'� i i • � • i _Ip..� s � . � i I ' �J � J` ' �