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: (406) 444-1971 Fax: (406) 444-9157 Check Amt $ Refund $ FEE SCHEDULE EFFECTIVE JULY 1, 2005 Submit correct fee per machine: July 1 through June 30 $220 per machine Oct. 1 through June 30 $165 per machine Jan. 1 through June 30 $110 per machine April 1 through June 30 $55 per machine AN IMPROPERLY COMPLETED OR INCOMPLETE APPLICATION WILL BE RETURNED. Type or print legibly using blue ink. GAMBLING ACCOUNT ID NUMBER (0000000-000-XXX) ESTABLISHMENT PHONE NUMBER Ma.

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How to fill out the Xxxdoj Form online

Filling out the Xxxdoj Form online can seem daunting, but with the right guidance, you can complete it with ease. This guide will provide a step-by-step approach to help you navigate each section of the form successfully.

Follow the steps to complete the Xxxdoj Form online.

  1. Click ‘Get Form’ button to obtain the form and open it in your preferred editing tool.
  2. Begin by entering your gambling account identification number in the required field. Ensure that you use the correct number provided by the Gambling Control Division.
  3. Fill in the establishment phone number and mailing address. If there are any changes to your mailing address, be sure to check the box indicating this change.
  4. Provide the establishment name exactly as it appears on your current gambling operator license and input the holder of the operator license details.
  5. Enter the Federal ID number in the specified field.
  6. Continue to the machine information section, where you will need to enter the necessary mechanical and electronic meter readings, VGMID number, and serial number.
  7. Designate the individuals authorized to sign your quarterly reports for machines owned by the establishment. Include their printed names and signatures.
  8. After completing the application, ensure to staple a correctly programmed audit ticket to the back of this form and staple your payment on the front where indicated.
  9. Finally, certify that the information provided is true and correct by printing your name, signing the form, and including the date.
  10. Once all sections are completed, save your changes, and download, print, or share the form as needed.

Complete your Xxxdoj Form online and ensure all information is accurate to avoid delays or returns.

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