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  • Pa Personal History Disclosure Form - Gaming Service Provider 2012

Get Pa Personal History Disclosure Form - Gaming Service Provider 2012-2025

I. COMPLETING THIS FORM: A. YOU MUST MAKE ACCURATE STATEMENTS AND INCLUDE ALL MATERIAL FACTS. ANY MISREPRESENTATION, FALSIFICATION, OMISSION OR THE FAILURE TO PROVIDE UPDATED REQUESTED INFORMATION, MAY RESULT IN THE DENIAL OF YOUR APPLICATION. B. SHOULD YOU BE UNABLE TO UNDERSTAND THIS FORM FULLY IN ENGLISH, IT IS YOUR RESPONSIBILITY TO ACQUIRE ADEQUATE MEANS OF TRANSLATION. IF YOU SUBMIT A DOCUMENT TO THE BOARD THAT IS IN A LANGUAGE OTHER THAN ENGLISH, YOU MUST ALSO SUBMIT AN ENGLISH TRANSLA.

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Related content

PENNSYLVANIA PERSONAL HISTORY DISCLOSURE FORM
INCLUDE ALL PART-TIME AND FULL-TIME EMPLOYMENT AND ANY. MILITARY SERVICE. FOR ANY CASINO...
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58 Pa. Code § 613a.3 - Qualification of...
A certified gaming related gaming service provider or applicant for gaming ... Holding...
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Official Inspection Station Certificate of...
This bond is effective beginning the date entered above, for a period of twelve (12)...
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licensees must petition the board to be licensed as a sports wagering certificate holder. They are required to pay a one-time fee of $10 million for sports betting and a $250,000 renewal fee is payable every five years.

Any questions or comments regarding patron disputes or complaints can be directed to the Director of Enforcement at 717-346-8300 or to complaints@state.pa.us.

DGS has an expedited certification process in place whereby an MBE and/or MBE may obtain its certification within six weeks.

CONTACT YOUR HUMAN RESOURCES OFFICE OR CONTACT THE PENNSYLVANIA GAMING CONTROL BOARD BUREAU OF LICENSING AT (877) 500-PGCB (7422). STANDARDS OR ORDERS IN EFFECT AS OF THE APPROVAL OF MY APPLICATION OR LATER AMENDED OR PROMULGATED BY THE BOARD. OTHER APPROVAL ISSUED BY THE BOARD IS A REVOCABLE PRIVILEGE.

A gaming service provider, once approved, will be registered or certified for a period of four years. Prior to the expiration of its registration or certification, the gaming service provider will be required to submit a renewal application in order to continue doing business with Pennsylvania slot machine licensees.

(i) Felony offense in any jurisdiction. (ii) Misdemeanor gambling offense in any jurisdiction, unless 15 years have elapsed from the date of conviction for the offense.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232