
Print Form ARKANSAS DEPARTMENT OF FINANCE AND ADMINISTRATION Bingo and Raffle Registration Licensed Authorized Organization Supplemental Form Clear Form AR-1R-BRLAO SECTION A OWNERSHIP INFORMATION 1 Legal Name Enter full legal name of organization - 2 Federal Identification Number FEIN SECTION B EVENT LOCATION INFORMATION 3 Location of event s Address City State Zip Check the appropriate box Premises are owned by the organization Premises are leased/rented by the organization - Attach copy of lease agreement Other explain SECTION C LICENSE TYPE 4 Type of License Original Renewal A 100. 00 Annual fiscal license to operate games of bingo and raffle B 25. 00 Temporary license to conduct one bingo session C 25. 00 Class I temporary license to conduct one raffle D 10. 00 Class II temporary license to conduct one raffle Prize donated and has a value less than 5 000. 00 If renewal application supply existing 8 digit Account ID -BRR SECTION D NON-PROFIT CERTIFICATION AND EVENT INFORMATION 5 Is....
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How to fill out the AR AR-1R-BRLAO online
Filling out the AR AR-1R-BRLAO form is an essential step for organizations looking to register for bingo and raffle events in Arkansas. This guide provides clear and supportive instructions on how to complete each section of the form online.
Follow the steps to accurately complete the AR AR-1R-BRLAO form.
- Press the ‘Get Form’ button to access the AR AR-1R-BRLAO form for editing.
- In Section A, enter the legal name of the organization and the federal identification number (FEIN) in the corresponding fields.
- Move to Section B, where you will provide the location of the event. Fill in the address, city, state, and zip code. Indicate whether the premises are owned by the organization, leased/rented (attach a lease agreement if applicable), or if another arrangement exists, and explain the situation.
- In Section C, select the type of license being applied for by checking the appropriate box. Specify whether it is an original application or a renewal, and provide the associated fees.
- Proceed to Section D. First, indicate if the organization is incorporated under 26 U.S.C. Section 501. Attach the required documents based on your answer. Then provide the type of organization and the date it was organized.
- List the charitable purposes for the proceeds of the bingo and raffle events. Next, for an annual license, indicate the days and times that bingo operations will be conducted.
- If applying for a temporary license, enter the specific date of the bingo or raffle session in the appropriate section.
- In Section E, the responsible party must certify their eligibility by confirming they have not been found guilty of a felony. This section requires the printed name and signature of the responsible party, as well as the date.
- After completing all sections, review the form for accuracy. Save changes, and when ready, download, print, or share the completed document as necessary.
Complete your AR AR-1R-BRLAO form online today to ensure a smooth registration process for your bingo and raffle events.
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