Fillable Form 490818: BENEFICIARY ORGANIZATION ASSISTING WITH BINGO SESSION (Kansas Department of Revenue)

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Form 490818: BENEFICIARY ORGANIZATION ASSISTING WITH BINGO SESSION (Kansas Department of Revenue)

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KANSAS DEPARTMENT OF REVENUE
BENEFICIARY ORGANIZATION ASSISTING WITH BINGO SESSION
Information on Licensed Organization
Bingo License Number
Name of Licensed Organization
Information on Beneciary Organization
Name of Beneciary Organization
Address of Organization
Stree City State Zip
Enter a description of how this organization became a beneciary of your organization:
Enter a description of the mission or purpose of this organization:
Beneciary President or Chairperson Information
Name
Address of President or Chairperson
Street City tate Zip
Daytime Phone Number
Name and address of members who will be helping with bingo sessions:
Name
Street City State Zip
Name
Street City State Zip
Name
Street City State Zip
Name
Street City State Zip
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Complete the above form and send to:
Kansas Department of Revenue
Division of Taxation
120 SE 10th Ave
PO Box 750680
Topeka KS 66625-0680
This form can be faxed to 785-296-4993. If you have questions call 785-368-8222 or go to our website at:
https://www.ksrevenue.org/bustaxtypesbingo.html
BI-6 (Rev. 8-19)
490818
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Form 490818: BENEFICIARY ORGANIZATION ASSISTING WITH BINGO SESSION (Kansas Department of Revenue)

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Completed 24 August 2020

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