§ 10-84. Application; fee.

(a)

A lessor or charitable organization, authorized organization or associational group or organization desiring to obtain a license under this division shall file with the county administrator or his designee a sworn application on forms supplied by the county administrator. The representative of the lessor or a charitable organization, authorized organization or associational group or organization 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, date of birth and social security number.

b.

An unincorporated organization, its full name and the names, dates of birth, social security numbers and residence addresses of its principal officers.

c.

A corporation, the exact corporate name and state of incorporation and the names, dates of birth, social security numbers and residence addresses of its principal officers and board of directors.

(2)

The representative's full name, date of birth, social security number and residence address.

(3)

Whether any of the individuals listed pursuant to subsections (a)(1) and (2) of this section has, within the five-year period immediately preceding, been convicted of any violation involving a theft or illegal gambling or of any felony under the laws of the state, the United States or any other state or has been convicted of any violation or similar violation involving a theft or illegal gambling or any felony or crime of equal nature under the laws of any foreign nation.

(4)

If any individual listed pursuant to subsections (a)(1) and (2) of this section is a naturalized citizen, the date and place of naturalization.

(5)

Whether the applicant has had any license under this article or a 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 instant bingo or to lease premises for the conduct of bingo or instant bingo.

(7)

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

(8)

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

(9)

If the license classification being applied for is:

a.

A class A license:

1.

The street address and ownership of the premises where the bingo or instant bingo games are to be conducted, if known at the time the application is filed, and each of them if more than one.

2.

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

3.

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

4.

The days of the week on which bingo or instant bingo games are to be conducted, and which for any applicant shall not exceed two days per week for bingo games.

5.

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

6.

At the time of renewal and every renewal thereafter, 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 and/or instant 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.

7.

Execute a form authorization authorizing the sheriff or his designee to inspect all books or other records of the applicant within 24 hours of any bingo or instant bingo game.

8.

Contain a list of volunteers to be used by the charitable organization. The volunteers set forth on the list must be bona fide members of the charitable organization and must have been members for at least 30 days prior to being listed and participate in other meaningful activities of the organization other than bingo or instant bingo. The applicant shall 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 who meet the membership requirements set forth in this subsection.

b.

A class B license:

1.

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

2.

If the applicant is not the owner of the premises, a statement that the premises are not owned by the applicant and if the premises are leased the period of time for which such premises have been leased by the applicant, which time period shall not be less than the time period prescribed in F.S. § 849.0931(11)(C).

3.

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

4.

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

5.

At the time of renewal and every renewal thereafter, a financial statement in the form prescribed by the county containing the sources and amount of the 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.

(10)

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

a.

If the applicant is a partnership, an executed copy of the partnership instrument.

b.

If the applicant is a corporation, the articles of incorporation with all amendments thereto and the charter issued by the secretary of state.

c.

If the applicant is an unincorporated organization, the constitution and bylaws of the organization.

(11)

Such other documentation related to the application as the county administrator or his designee may require, which documentation shall be in addition to the items set forth in this section and shall be directed toward completing a full disclosure of all items mentioned in this section.

(12)

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.

(b)

Each application shall be accompanied by a nonrefundable fee of $50.00 in accordance with the development services branch fee resolution.

(Code 1970, § 16½-88; Ord. No. 92-15, § 8, 10-27-92; Ord. No. 93-08, § 2, 4-6-93; Ord. No. 93-18, § 8, 6-8-93; Ord. No. 06-07, § 5, 2-28-06; Ord. No. 08-40, § 1, 9-23-08; Ord. No. 14-23, § 4, 9-9-14)