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Get NY BJ-GC-2 2006

347-1469 www.racing.state.ny.us GAMES OF CHANCE (Casino Nights, Bazaars, Carnivals) BELL JAR RAFFLE (only raffles w/ over $30,000 net profits in calendar year) FOR OFFICE USE ONLY $ Municipal License Number / Fees Received Date / INSTRUCTIONS: PLEASE FILE THREE SIGNED COPIES WITH MUNICIPALITY GC - - - - N.Y.S. Identification Number IT IS A MISDEMEANOR TO MAKE ANY FALSE STATEMENTS IN THIS APPLICATION Name of Municipality County PART A. GENERAL 1. Name of Organization 2. Address.

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