Iowa Administrative Code › Agency 491 - Racing and Gaming Commission › Chapter 1 - Organization and Operation › Rule 491-1.5 - Forms

Current through Register Vol. 47, No. 3, July 24, 2024
All forms utilized in the conduct of business with the racing
				and gaming commission shall be available from the commission upon request.
				These forms include but are not limited to:
(1)
Racing, gambling structure, or
			 excursion gambling boat license application.
This form shall contain
			 at a minimum the full name of the applicant, all ownership interests, balance
			 sheets and profit-and-loss statements for three fiscal years immediately
			 preceding the application, pending legal action, location and physical plant of
			 the facility, and description of proposed operation. The form may include other
			 information the commission deems necessary to make a decision on the license
			 application. The qualified nonprofit corporation and the boat operator, if
			 different than the qualified nonprofit corporation, shall pay a nonrefundable
			 application fee in the amount of $25,000 to offset the commission's cost for
			 processing the application. Additionally, the applicant shall remit an
			 investigative fee of $30,000 to the department of public safety to do
			 background investigations as required by the commission. The department of
			 public safety shall bill the applicant/licensee for additional fees as
			 appropriate and refund any unused portion of the investigative fee within 90
			 days after the denial or operation begins.
(2)
Renewal application for racing
			 license.
This form shall contain, at a minimum, the full name of the
			 applicant, racing dates, simulcast proposal, feasibility of racing facility,
			 distribution to qualified sponsoring organizations, table of organization,
			 management agreement, articles of incorporation and bylaws, lease agreements,
			 financial statements, information on the gambling treatment program, and
			 description of racetrack operations. The form may include other information the
			 commission deems necessary to make a decision on the license
			 application.
(3)
Renewal
			 application for excursion gambling boat or gambling structure license.
This form shall contain, at a minimum, the full name of the applicant, annual
			 fee, distribution to qualified sponsoring organizations, table of organization,
			 internal controls, operating agreement, hours of operation, casino operations,
			 Iowa resources, contracts, guarantee bond, notarized certification of
			 truthfulness, and gambling treatment program. The form may include other
			 information the commission deems necessary to make a decision on the license
			 application. An annual fee to operate an excursion gambling boat shall be based
			 on the passenger-carrying capacity including crew. For a gambling structure,
			 the annual license fee shall be based on the capacity of the gambling
			 structure. The fee shall be $5 per person capacity and accompany this
			 application.
(4)
Renewal
			 application for racetrack enclosure license.
This form shall contain,
			 at a minimum, the full name of the applicant, annual fee, casino operations,
			 internal controls, Iowa resources, guarantee bond, and notarized certification
			 of truthfulness. The form may include other information the commission deems
			 necessary to make a decision on the license application. A $1,000 application
			 fee must accompany this license application.
(5)
Occupational license
			 application.
This form shall contain, at a minimum, the applicant's
			 full name, social security number, residence, date of birth, and other personal
			 identifying information that the commission deems necessary. A fee set by the
			 commission shall apply to this application. (Refer to 491-Chapter 6 for
			 additional information.)
(6)
Season approvals.
This form shall contain, at a minimum, a
			 listing of the department heads and racing officials, minimum purse, purse
			 supplements for Iowa-breds, grading system (greyhound racing only), schedule
			 and wagering format, equipment, security plan, certification, and any other
			 information the commission deems necessary for approval. This request must be
			 submitted 45 days prior to the meet. Any changes to the items approved by the
			 commission shall be requested in writing by the licensee and subject to the
			 written approval of the administrator or commission representative before the
			 change occurs.
(7)
Manufacturers and distributors license application.
This form
			 shall contain at a minimum the full name of the applicant, all ownership
			 interests, balance sheets and profit-and-loss statements for three fiscal years
			 immediately preceding the application, pending legal action, location and
			 physical plant of the applicant, and description of proposed operation. The
			 form may include other information the administrator deems necessary to make a
			 decision on the license application. A license fee of $1,000 for a
			 distributor's license and a license fee of $250 for a manufacturer's license
			 shall accompany this application. (Refer to 491-Chapter 11 for additional
			 information.)
(8)
Advance
			 deposit wagering license application.
This form shall contain at a
			 minimum the full name of the applicant, all ownership interests, balance sheets
			 and profit-and-loss statements for three fiscal years immediately preceding the
			 application, pending legal action, location and physical plant of the
			 applicant, and description of proposed operation. The form may include other
			 information the administrator deems necessary to make a decision on the license
			 application. A license fee of $1,000 shall accompany this application. (Refer
			 to 491-Chapter 8 for additional information.)
(9)
Asset/stock purchase form for
			 commission approval.
This form shall contain at a minimum the full
			 name of the applicant, all ownership interests, balance sheets and
			 profit-and-loss statements for three fiscal years immediately preceding the
			 application, pending legal action, location and physical plant of the
			 applicant, and description of proposed operation. The form may include other
			 information the administrator deems necessary to make a decision.
(10)
Sports wagering for excursion
			 gambling boat, gambling structure or racetrack enclosure application.
This form shall contain, at a minimum, the full name of the applicant,
			 disclosure of agreements involving sports wagering, a guarantee bond in an
			 amount as determined by the commission, and a notarized certification of
			 truthfulness. The applicant shall pay a nonrefundable application fee in the
			 amount of $45,000 to the commission.
(11)
Renewal application for sports
			 wagering for excursion gambling boat, gambling structure or racetrack
			 enclosure.
This form shall contain, at a minimum, the full name of the
			 applicant, a $10,000 annual fee, disclosure of agreements involving sports
			 wagering, sports wagering operations, internal controls, a guarantee bond in an
			 amount as determined by the commission, a gambling treatment program, and a
			 notarized certification of truthfulness. The form may include other information
			 the commission deems necessary to make a decision on the license
			 application.
(12)
Advance
			 deposit sports wagering operator application.
This form shall contain,
			 at a minimum, the full name of the applicant, all ownership interests, balance
			 sheets and profit-and-loss statements for three fiscal years immediately
			 preceding the application, pending legal action, agreement with licensed
			 facility or description of proposed operation, a gambling treatment program,
			 and a notarized certification of truthfulness. The form may include other
			 information the commission deems necessary to make a decision on the license
			 application.
(13)
Internet
			 fantasy sports contest application.
This form shall contain, at a
			 minimum, the full name of the applicant, board members, all ownership
			 interests, balance sheets and profit-and-loss statements for the fiscal year
			 immediately preceding the application, pending legal action, proof of
			 satisfactory segregation of internet fantasy sports contest player contest
			 funds as determined by the commission, a description of the proposed operation
			 and a notarized certification of truthfulness. The form may include other
			 information the commission deems necessary to make a decision on the license
			 application.
(14)
Alternative simulcast license application.
This form shall
			 contain, at a minimum, the full name of the applicant, all ownership interests,
			 balance sheets and profit-and-loss statements for three fiscal years
			 immediately preceding the application, pending legal action, agreement with
			 licensed facility or description of proposed operation, and a notarized
			 certification of truthfulness. The form may include other information the
			 commission deems necessary to make a decision on the license
			 application.