Or. Admin. Code § 137-025-0117 - Application for Linked Progressive Bingo Game Escrow Agent

(1) An application for a Linked Progressive Bingo Game Escrow Agent 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 must 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 person or organization;

(b) A statement as to whether or not the person or organization has had a license to provide equipment or services for bingo or other gambling activity denied, revoked or suspended by the State of Oregon or any other licensing authority; and

(c) The full name(s) and physical address(s) of the responsible official(s) of the applicant.

(2) The applicant shall submit the following documents with the application. The information required in subsections (b) and (c) of this section shall be on forms prescribed by the Department and shall be signed by a responsible official of the applicant:

(a) Proof of compliance with applicable state and local business registration laws and regulations.

(b) As required by Oregon ORS 464.280, 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;

(c) A consent to allow Department employees access to licensees' place of business for inspection of equipment and to examine records maintained by licensees.

(d) Such other information as requested by the Department.

(3) The non-refundable application and licensing investigation fee is $50 for an applicant licensed pursuant to ORS 696.505 et seq. The fee for all other applicants is $250.

Notes

Or. Admin. Code § 137-025-0117

DOJ 8-2004, f. & cert. ef. 5-19-04

Stat. Auth.: ORS 167.117(10)(12), 464.250(1), 914

Stats. Implemented: SB 716, 2003