The organization that will conduct bingo must fill out an application to conduct bingo every year. You are responsible for initiating a renewal application each year.
Each organization shall have a minimum of two officers/ operators with Bingo Application of Officers/ Operators on file for each.
If you are renewing your Bingo Permit and there are no officer/ operator changes from last year, you only need to complete this form.
Upon the change of any information provided in this application, the licensee shall immediately submit to the director of public safety of the city of Rohnert Park an amendment to this application stating such changes.
Include address, City, State and Zip code.
Provide the address where bingo will be played.
If rented/leased what is the rental fee?
If rented or leased what is the rental/ lease time period?
Provide a schedule on when bingo will be played. Include what days of the week and times.
Provide the name, address and phone number for the person responsible for your organizations financial records.
Attach a copy of any and all revisions or amendments to the Articles of Incorporation, Constitution, bylaws or other rules governing the organization or its use of funds.
Attach a roster of present officers and directors. Include name, address and phone number for each.
Attach a copy of your organization's most recent financial report.
Attach your organization's proposed charitable budget for the coming year, and anticipated use of the funds to be raised and estimated bingo revenues to be raised for that period. Estimated receipts and expenses for the year together with such other information relevant to the application as required and approved by the Director of Public Safety
List the location of all special bingo bank account(s), name and address of bank, account number(s) and authorized signatures. List every account into which bingo funds were deposited or transferred, or from which bingo funds were finally disbursed to charity.
Attach a copy of the applicant's rules of the bingo game(s), type of games to be played and prizes to be awarded for each game.
Provide the names of all volunteer members of the applicant organization who will staff bingo game(s).
Attach blank copies of all forms used to track bingo sales, reconcile cash collected and control inventory at bingo games. Blank copies of any other control or balancing forms used by bookkeeper to control cash and inventory.
Attached a copy of your organizations audit opinion pursuant to Section 9.66.260 of Rohnert Park Municipal Code
Upon the change of any information provided in this application, the licensee shall immediately submit to the Director of Public Safety of the City of Rohnert Park an amendment to this application stating such changes.
Under penalty of perjury in accordance with the laws of the State of California, by signature, we certify that the applicant organization:
Type First and Last Name
(P.C. 316.5; Rev & Tax Code 23701(d))
Attach a copy of your organizations active exempt status provided by the State of California Franchise Tax Board and/or Internal Revenue Service.
P.C. 326.5(a)
P.C. 325.5(h)
P.C. 326.5(f)
P.C. 326.5(j)
The below signed person(s) represent that they have read a copy of the Bingo Ordinance provided by the Rohnert Park Department of Public Safety and agree to conduct Bingo Games in full compliance with the provisions of Section 326.5 of the California Penal Code and the City of Rohnert Park Ordinance No. 892. I declare under penalty of perjury under the laws of the State of California that the foregoing information is true and correct.
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