§ 10-118. License application; fee.

Application. A person desiring to obtain a license under this article shall file with the county a sworn application on forms supplied by the county. The designated representative or officer of the applying person shall file the application and execute the oath. The application shall contain at least the following information:

(1)

If the applicant is:

a.

An individual, his name, residence address and a statement that the applicant is age 18 or older.

b.

An unincorporated organization, its full name and the names, ages and residence addresses of its principal officers.

c.

A corporation, the exact corporate name and state of incorporation and the names, ages and residence addresses of its principal officers and board of directors.

(2)

Full name, a statement that the applicant is age 18 or older, and residence address of the signing officer or representative.

(3)

Whether any of the individuals listed pursuant to subsections (1) and (2) has, within the five-year period immediately preceding, been convicted of any misdemeanor involving a theft or illegal gambling, or of any felony under the laws of the state, the United States or any other state and, if so, the particular criminal act involved and the place of conviction.

(4)

If the person signing the application is a naturalized citizen, the date and place of naturalization.

(5)

Whether the applicant has had any license under this article or a bingo license issued by any other jurisdiction revoked or suspended and, if so, the date of each revocation or suspension.

(6)

The names of all municipalities or counties where an application has been made for a license to conduct bingo or to lease premises for the conduct of bingo.

(7)

The name of each bank in which the net proceeds from the conduct of bingo or fees from the lease of any premises for the conduct of bingo are to be deposited.

(8)

The classification of the licenses for which the application is being filed.

(9)

If the license classification being applied for is a Class A license, the applicant must:

a.

State the street address and ownership of the premises where the bingo games are to be conducted, if known at the time the application is filed.

b.

Provide the applicant's current 501(c) of the Internal Revenue Code of 1954 or current exemption certificate issued under Section 528 of the Internal Revenue Code of 1986, as amended.

c.

If the applicant is a corporation, provide the applicant's nonprofit charter or if not a corporation such other documentation as will demonstrate nonprofit charitable purpose of the applicant. If such information is not satisfactory to the county, then it may request the applicant to produce other evidence such as will confirm the nonprofit charitable status of applicant to the county.

d.

State the days of the week on which bingo games are to be conducted.

e.

If the applicant is a branch, chapter, lodge, agency or other local unit of a nonprofit charitable or authorized organization, provide the name of the primary organization and the street address of its principal office.

f.

At the time of renewal and every renewal thereafter, file a financial statement in the form prescribed by the county, containing the sources and amount of the gross revenue derived by the applicant from the conduct of bingo during the 12-month period immediately prior to the date of the application and stating the names of the distributees of the net revenues and the amounts received by each, together with executed receipts signed by each distributee acknowledging receipt of the funds, which statement must be certified as correct by a principal officer, one of the partners or any similar principal, but need not be audited.

g.

Execute a form authorizing the county or its designee to inspect all books or other records of applicant upon 24 hours notice.

h.

Provide a list of volunteers to be used by the charitable organization and execute a form agreeing to update such list any time changes are made. Such list shall at all times only contain the names of volunteers meeting the membership requirements set forth in this article.

(10)

If the license being applied for is a Class B license, the applicant shall:

a.

State the street address and ownership of the premises for which the license is being sought.

b.

If the applicant is not the owner of the premises, provide evidence of the owner of the premises which may be a deed to the premises or a title opinion from a Florida attorney.

c.

If the applicant is leasing premises from another nonprofit organization qualified under this article, provide the class and date of issuance of the license held by the other organization.

d.

Attach fully executed copies of any rental agreements, leases or subleases presently existing or proposed involving the premises sought to be used by applicant and an executed form whereby applicant agrees to submit a copy of any lease, sublease, rental agreement or lease amendment that the applicant enters into during the time the license is in effect.

e.

At the time of renewal and every renewal thereafter, file a financial statement, in the form prescribed by the county, containing the sources and amount of applicant's gross revenue during the 12-month period ending immediately prior to the date of the application, which statement must be certified as correct by a principal officer, one of the partners or any similar principal, but need not be audited.

(11)

If the applicant is a partnership, corporation or unincorporated organization, the application, in addition to other documentation required herein will be accompanied by the following applicable additional documents:

a.

An executed copy of the partnership instrument.

b.

The bylaws and articles of incorporation with all amendments thereto and the charter issued by the secretary of state.

c.

The charter and bylaws of the organization.

(12)

Such other documentation related to the application as the county may require for the purpose of completing a full disclosure of all ownership, leasing status, membership and other licensing criteria mentioned herein.

(13)

A notarized statement certifying that all information on the application and any submittals or attachments thereto is true and that the applicant understands that any misstatement of material fact in the application will result in the denial of the license or, if it has been issued, in the suspension or revocation of the license.

(14)

A nonrefundable fee of $50.00 or such other fee as may be adopted by resolution of the county commission to cover costs of review, investigation and administration.

(Ord. No. 95-25, § 8, 5-25-95)