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OFFICE USE ONLY Control Number LOTTERY RETAILER LICENSE APPLICATION NORTH DAKOTA OFFICE OF ATTORNEY GENERAL LOTTERY DIVISION
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Document Date: 2013-06-20 12:06:33

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City

Bismarck / /

Company

Credit Check (please check one) Sole Proprietor ($3) Partnership ($35) Corporation / Street Address County Mailing Address (if different than business address) Partnership Corporation LLC / /

Currency

USD / /

Facility

Convenience Store / Casino Restaurant / Plaza Other / Supermarket Free-standing Bar / Club Strip Shopping Center Gas / Service Station Liquor Store Mall Truck Stop / /

IndustryTerm

retail alcoholic beverage license / state government services / alcohol products / licensed retailer / satellite telecommunications / license applications / retailer license applications / /

Organization

OFFICE USE ONLY Control Number LOTTERY RETAILER LICENSE APPLICATION NORTH DAKOTA OFFICE OF ATTORNEY GENERAL LOTTERY DIVISION SFN / OFFICE OF ATTORNEY GENERAL LOTTERY DIVISION SFN / Contact Lottery Division / ND Tax Department / North Dakota office of State Tax / Lottery Division / /

/

Position

Attorney General / proprietor / officer / director / Commissioner / corporate director and officer / /

ProvinceOrState

North Dakota / North / /

Technology

satellite telecommunications / /

SocialTag