Fillable RAFFLE LICENSE APPLICATION (Village of Sugar Grove)

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RAFFLE LICENSE APPLICATION (Village of Sugar Grove)

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Country of origin: US
File type: PDF

U.S.A. forms for Village of Sugar Grove

BROWSE VILLAGE OF SUGAR GROVE (IL) FORMS

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10 S. Municipal Drive
Sugar Grove, Illinois 60554
P 630-391-7200 / F 630-391-7210
www.sugargroveil.gov
RAFFLE LICENSE APPLICATION
Organization Name:
Organization Address:
________________________________________________________________________
Mailing Address (if different from above): ______________________________________
________________________________________________________________________
Type of Organization:
Length of Time Organization has been in Existence:
Place and Date of Corporation’s Charter: _______________________________________
President/Chairperson’s Name: ___________________________________________________
Address: _______________________________________________________________________
Phone Number: __________________________________________________________________
Email Address: __________________________________________________________________
Secretary Name: _______________________________________________________________
Address: _______________________________________________________________________
Phone Number: __________________________________________________________________
Email Address: __________________________________________________________________
Raffle Managers Name: __________________________________________________________
Address: _______________________________________________________________________
Phone Number: __________________________________________________________________
Email Address: __________________________________________________________________
Treasurer’s Name: ______________________________________________________________
Address: _______________________________________________________________________
Phone Number: __________________________________________________________________
Email Address: __________________________________________________________________
Religion
☐
Community Association
☐
Labor
☐
Educational
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Veterans
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Non-profit Fund Raising
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Fraternal
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Charitable
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mmmmmmmmmm
Date of Raffle Drawing:
Address/ Location of Raffle Drawing:
Price of Raffle Ticket:
Raffle Tickets will be sold from ____________ to ___________ (Not to exceed 180 days)
Date Date
Area(s) in which Raffle Tickets will be sold: ____________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
The undersigned hereby attests that the above-named applicant is registered as a not-for-
profit organization under the law of the State of Illinois and has been continuously in
existence for five (5) years preceding this application and, that during this five (5) year
period preceding date of application, it has maintained a bona fide membership actively
engaged in carrying out its objectives. The undersigned does hereby state under penalties
of perjury that all statements in the foregoing application are true and correct; that the
officers, operators and workers of the raffle are bona fine members of the sponsoring
organization and are all of good moral character and have not been convicted of a felony;
that if a license is granted hereunder, the undersigned will be responsible for the conduct
of the raffle in accordance with the provisions of the laws of the State of Illinois and this
jurisdiction governing the conduct of such raffle.
Applicant (sign & date)
Treasurer (sign & date)
Attest:
Secretary (sign & date)
List of Prizes and Retail Cost of Prizes to be Awarded:
Prize
Retail Costs
TOTAL:
Raffle License Fee Schedule is as follows:
AGGREGATE PRIZE VALUE
Less than $500.00……………………………... None
$501.00 to $5,000.00………………………….$ 40.00
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RAFFLE LICENSE APPLICATION (Village of Sugar Grove)

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Completed 16 July 2020

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