Distributor Forms

Minnesota Gambling Control Board
1711 West County Road B, Suite 300 South
Roseville, Minnesota 55113
651-639-4000

The five forms of lawful gambling are
raffles, bingo, pull-tabs, tipboards, and paddlewheels.

Information and Forms
for
Distributors of Lawful Gambling Equipment in Minnesota.
To return to the Minnesota Gambling Control Board home page, click here.

Who is required to obtain a distributor's license?

A distributor's license must be obtained by any person or entity distributing lawful gambling equipment in Minnesota.

Lawful gambling equipment means disposable equipment that includes:

bingo hard cards and bingo paper sheets,

paper pull-tabs,

electronic pull-tabs,

jar tickets,

paddletickets and paddleticket cards,

tipboards and tipboard tickets, and

promotional tickets that mimic a pull-tab or tipboard.

Lawful gambling equipment also means permanent equipment that includes:

devices for selecting bingo numbers,

electronic bingo devices,

electronic pull-tab devices,

pull-tab dispensing devices for paper pull-tabs,

programmable electronic devices that have no effect on the outcome of a game and are used to provide a visual or auditory enhancement of a game, and

paddlewheels, and

paddlewheel tables.

How much is the application fee?

The application fee is $6,000. A license is valid for one year.

What do we submit to apply for a distributor's license?

Submit the following to the Minnesota Gambling Control Board.

1. LG400 Application for License to Distribute Gambling Equipment.

2. LG410 Distributor Personnel Information.
The following persons must complete the LG410 Distributor Personnel Information form: owners, officers, directors, partners, managers, supervisors, persons or entities with a direct or indirect financial interest of five percent or more, and consultants.

3. Any person who will be employed to sell, offer for sale, or furnish lawful gambling equipment must obtain a distributor's salesperson license and be employed by a licensed distributor. To apply for a salesperson license, use
LG411 Distributor Salesperson License Application. The application fee is $100. A license is valid for one year. The application process may take up to four weeks

4. LG412 Distributor Nonsales Employee Information form must be completed by all distributor employees who are not sales employees.

Background checks.
Completed application forms are sent to the Department of Public Safety for a background check and to the Department of Revenue for a tax clearance. You will be charged for any background investigation expenses.

Upon receipt of the completed background check and tax clearance, your application will be presented to the Minnesota Gambling Control Board for consideration at a monthly board meeting.

Questions regarding the license application?
Call the Minnesota Gambling Control Board at 651-639-4079 or 651-639-4000. Or, e-mail our licensing specialist.

Minnesota statutes and rules governing licensed distributors of lawful gambling equipment.
Minnesota Statute 349.161 Distributor License.
Minnesota Statute 297E Gambling Taxes.
Minnesota Rules 7863.0210 Distributor License.
Minnesota Rules 7863.0220 Distributor Operations, Accounts and Reports

The following forms are used in a distributor's business.

LG420 Distributor to Organization Lease Agreement for Pull-Tab Dispensing Device.

LG423 Distributor to Organization Sales Agreement for Pull-Tab Dispensing Device.

LG460 Distributor Pricing Report. For further information call 651-639-4086.

LG461 Delinquent Organization Report.

LG431 State Registration Stamp Order Form. State registration stamps must be placed on permanent gambling equipment which is defined as devices for selecting bingo numbers, paddlewheels, paddlewheel tables, and pull-tab dispensing devices.

LG432 Registration of Permanent Equipment.

LG422 Distributor License Termination Plan.
Department of Revenue information.

To return to the Minnesota Gambling Control Board home, click here.

	Minnesota Gambling Control Board 1711 West County Road B, Suite 300 South Roseville, Minnesota 55113 651-639-4000 The five forms of lawful gambling are raffles, bingo, pull-tabs, tipboards, and paddlewheels.
Information and Forms for Distributors of Lawful Gambling Equipment in Minnesota. To return to the Minnesota Gambling Control Board home page, click here.
Who is required to obtain a distributor's license? A distributor's license must be obtained by any person or entity distributing lawful gambling equipment in Minnesota. Lawful gambling equipment means disposable equipment that includes: bingo hard cards and bingo paper sheets, paper pull-tabs, electronic pull-tabs, jar tickets, paddletickets and paddleticket cards, tipboards and tipboard tickets, and promotional tickets that mimic a pull-tab or tipboard. Lawful gambling equipment also means permanent equipment that includes: devices for selecting bingo numbers, electronic bingo devices, electronic pull-tab devices, pull-tab dispensing devices for paper pull-tabs, programmable electronic devices that have no effect on the outcome of a game and are used to provide a visual or auditory enhancement of a game, and paddlewheels, and paddlewheel tables. How much is the application fee? The application fee is $6,000. A license is valid for one year. What do we submit to apply for a distributor's license? Submit the following to the Minnesota Gambling Control Board. 1. LG400 Application for License to Distribute Gambling Equipment. 2. LG410 Distributor Personnel Information. The following persons must complete the LG410 Distributor Personnel Information form: owners, officers, directors, partners, managers, supervisors, persons or entities with a direct or indirect financial interest of five percent or more, and consultants. 3. Any person who will be employed to sell, offer for sale, or furnish lawful gambling equipment must obtain a distributor's salesperson license and be employed by a licensed distributor. To apply for a salesperson license, use LG411 Distributor Salesperson License Application. The application fee is $100. A license is valid for one year. The application process may take up to four weeks 4. LG412 Distributor Nonsales Employee Information form must be completed by all distributor employees who are not sales employees. Background checks. Completed application forms are sent to the Department of Public Safety for a background check and to the Department of Revenue for a tax clearance. You will be charged for any background investigation expenses. Upon receipt of the completed background check and tax clearance, your application will be presented to the Minnesota Gambling Control Board for consideration at a monthly board meeting. Questions regarding the license application? Call the Minnesota Gambling Control Board at 651-639-4079 or 651-639-4000. Or, e-mail our licensing specialist. Minnesota statutes and rules governing licensed distributors of lawful gambling equipment. Minnesota Statute 349.161 Distributor License. Minnesota Statute 297E Gambling Taxes. Minnesota Rules 7863.0210 Distributor License. Minnesota Rules 7863.0220 Distributor Operations, Accounts and Reports
The following forms are used in a distributor's business.
LG420 Distributor to Organization Lease Agreement for Pull-Tab Dispensing Device. LG423 Distributor to Organization Sales Agreement for Pull-Tab Dispensing Device. LG460 Distributor Pricing Report. For further information call 651-639-4086. LG461 Delinquent Organization Report. LG431 State Registration Stamp Order Form. State registration stamps must be placed on permanent gambling equipment which is defined as devices for selecting bingo numbers, paddlewheels, paddlewheel tables, and pull-tab dispensing devices. LG432 Registration of Permanent Equipment. LG422 Distributor License Termination Plan. Department of Revenue information.
To return to the Minnesota Gambling Control Board home, click here.