RENTAL AGREEMENT OFFICE OF ATTORNEY GENERAL LICENSING SECTIONRental Agreement • July 23rd, 2019
Contract Type FiledJuly 23rd, 2019Site Owner (Lessor) Site Name Site Phone Number Site Address City State Zip Code County Organization (Lessee) Rental Period to Monthly Rent Amount 1. Is Bingo going to be conducted at this site?1a. If "Yes" to number 1 above, is Bingo the primary game conducted?If ''Yes," enter the monthly rent amount to be paid. Then answer questions 2 - 7 but do not enter any rent amounts. No No Yes Yes $ 2 Is Twenty-One conducted at this site? x Rent per Table $ . Number of Tables with wagers up to $5Number of Tables with wagers over $5 x Rent per Table $ No Yes $ $ 3. Is Paddlewheels conducted at this site? x Rent per Table $ Number of Tables No Yes $ 4. Is Pull Tabs involving either a jar bar, standard, or electronic dispensing device conducted at this site?Please check: Jar Bar Standard Dispensing Device No Yes $ Electronic Dispensing Device Number of Electronic Devices $ Total Monthly Rent $ 5. If the only gaming activity to be conducted at this site is a raffle drawing,
RENTAL AGREEMENT OFFICE OF ATTORNEY GENERAL LICENSING SECTIONRental Agreement • July 23rd, 2019
Contract Type FiledJuly 23rd, 2019Site Owner (Lessor) Site Name Site Phone Number Site Address City State Zip Code County Organization (Lessee) Rental Periodto Monthly Rent Amount 1. Is Bingo going to be conducted at this site? No1a. If "Yes" to number 1 above, is Bingo the primary game conducted?If ''Yes," enter the monthly rent amount to be paid. Then answer questions 2 - 7 but do not No enter any rent amounts. Yes Yes $ 2 Is Twenty-One conducted at this site? x Rent per Table $ No. Number of Tables with wagers up to $5Number of Tables with wagers over $5 x Rent per Table $ Yes $ $ 3. Is Paddlewheels conducted at this site? x Rent per Table $ No Number of Tables Yes $ 4. Is Pull Tabs involving either a jar bar, standard, or electronic dispensing device conducted at this site? No Please check: Jar Bar Standard Dispensing Device Yes $ Electronic Dispensing Device Number of Electronic Devices $ Total Monthly Rent $ 5. If the only gaming activity to be conducted at this site is a raffle drawing, please check her