West Virginia Code of State Rules › Agency 179 - Lottery Commission › Title 179 - LEGISLATIVE RULE WEST VIRGINIA LOTTERY › Series 179-04 - Limited Gaming Facility Rules › Part 3 - LICENSES › Section 179-4-51 - Applications for Occupational Licenses

Current through Register Vol. XLI, No. 28, July 12, 2024
51.1. An applicant for an occupational
				  license, level one or level two, shall complete and submit an application and
				  personal disclosure form to the Commission. The applicant shall submit the
				  application and disclosure form in the manner and form prescribed by the
				  Commission at Lottery Headquarters or any other location specified by the
				  Commission. The application and personal disclosure forms prescribed by the
				  Commission may require the applicant to provide any of the following
				  information and documents with respect to the applicant:
51.1.a. The applicant's name, including any
				  aliases or nicknames;
51.1.b. The
				  applicant's date of birth and copy of his or her birth certificate;
51.1.c. The applicant's physical
				  description;
51.1.d. The
				  applicant's current address and residence history;
51.1.e. Marital history, dependents, and
				  other family data;
51.1.f. The
				  nature of the applicant's position with or interest in the limited gaming
				  facility;
51.1.g. The applicant's
				  current home and business or work telephone numbers;
51.1.h. The applicant's employment history of
				  the applicant;
51.1.i. Record of
				  military service;
51.1.j.
				  Government positions and offices presently and previously held, and offices,
				  trusteeships, directorships, or fiduciary positions presently or previously
				  held with any business entity;
51.1.k. Licenses and other government permits
				  or approvals presently and previously held by the applicant;
51.1.l. A denial, suspension, or revocation
				  by a government agency of any license, permit, or certification held by, or
				  applied for by, the applicant;
51.1.m. The convictions of the applicant for
				  a misdemeanor related to theft, bribery, gambling, or involving moral
				  turpitude, or any felony;
51.1.n.
				  The information specified and required by the Act, including a photograph and
				  the applicant's fingerprints taken at a time or place, or both, specified by
				  the Commission;
51.1.o. Financial
				  information for the applicant, including, but not limited to:
51.1.o.1. A statement of assets and
				  liabilities and net worth;
51.1.o.2. Bank accounts;
51.1.o.3. Loans;
51.1.o.4. Notes;
51.1.o.5. Real estate interests;
51.1.o.6. Mortgages and liens;
51.1.o.7. Life insurance;
51.1.o.8. Pension funds;
51.1.o.9. Real estate and income tax
				  payables;
51.1.o.10. Credit
				  score;
51.1.o.11. Vehicles;
				  and
51.1.o.12. Other
				  assets;
51.1.p. Judgments
				  and petitions for bankruptcies or insolvency concerning the applicant or any
				  business entity in which the applicant held a 5% or more interest, other than a
				  publicly traded company, or in which the applicant services as an officer or
				  director;
51.1.q. A garnishment or
				  attachment of wages, charging order or voluntary wage execution, or other
				  formal proceedings to adjust, defer, suspend, or otherwise work out the payment
				  of a debt of the applicant;
51.1.r.
				  Other confidential financial and business information;
51.1.s. The applicant's education and
				  training;
51.1.t. All required
				  waivers and affidavits prescribed by the Commission; and
51.1.u. Other information or documents that
				  the Commission considers necessary and relevant to determine the applicant's
				  identity, eligibility, qualifications, and suitability for licensure under the
				  Act or this rule.