2. Notice is hereby given that the following organization:
4. Name of Organization
6. is a: (Check One)

   1. 1) Bona Fide Congressionally Chartered Veterans'
   2. 2) Religious Charitable Educational or Fraternal
   3. 3) Local Civic or Service Club
   4. 4) Political Party
   5. 5) Volunteer Fire Department
   6. 6) Local Industrial Development Corporation
   7. 7) Political Action Committee
   8. 8) Political Committee on Behalf of a Candidate for Political Office in SD
7. Type:

   1. 1) Bingo
   2. 2) Lottery
9. Duly existing under the laws of the State of South Dakota, that wishes to conduct a bingo or lottery in Watertown, SD pursuant to SDCL 22-25-25. Please provide the following information:
11. Contact Person
12. Phone Number
13. E-mail Address
15. Address
16. City, State Zip
18. Start Date
    Start Date
19. End Date
    End Date
20. Bingo or Lottery Event Date
    Bingo or Lottery Event Date

    Bingo or Lottery Event Date
22. Proceeds from the bingo or lottery will be used as follows:
24. Prizes to be Awarded
26. Please indicate you have read the following rules by placing a check in the corresponding box on the left.
28. Rules

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5
    6. 6
29. Rules
    1) No separate organization or professional person is/will be employed to conduct the bingo or lottery;
    
    2) No compensation of any kind in excess of the state minimum wage per hour or sixty dollars (whichever is greater) in value is paid to any person for rendering service to conduct any bingo/lottery. The provisions of this subsection do not apply to bingo/lottery conducted in connection with a county fair (SDCL 7-27-3), the state fair (SDCL Chapter 1-21), or a civic celebration recognized by resolution of the governing body;
    
    3) No prize in excess of two thousand dollars ($2,000.00) is awarded at any one play of bingo;
    
    4) The actual value of any lottery prize is stated before any chances for the lottery are sold. A lottery prize of a stated amount of dollars in value may be given to a person who sells a winning lottery ticket or share as long as the winning lottery ticket or share is selected at random;
    
    5) Authorized organizations, before conducting a bingo game or before selling any chances for a lottery give thirty (30) days written notice of the time and place thereof to the designated administrative official of the municipality in which it intends to conduct the bingo game or lottery, provided there is no objection;
    
    6) No authorized organization may enter into any lease or agreement with any other person or organization to provide equipment or services associated with the conduct of a bingo game or lottery except a distributor licensed pursuant to SDCL 22-25-28 to 22-25-51, inclusive, to provide bingo or lottery equipment and supplies.
31. Signature
32. Date
    Date
34. For Finance Office Use Only

    1. Approved

    1. Not Approved
36. Administrative Official Signature
37. Date
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit Submit and Print

* indicates a required field