The Maryland Lottery License form is a crucial document for businesses wishing to offer lottery games and services in the state of Maryland. It serves as an application for obtaining the necessary approval to legally conduct lottery-related activities. For those interested in exploring the lucrative world of lottery sales and games, ensure you complete the form by clicking the button below.
In the state of Maryland, individuals or entities interested in participating in the lottery industry must navigate through the essential legal requirement of obtaining a Maryland Lottery License. This process is initiated through the completion and submission of a specific form, designed to gather comprehensive information about the applicant, including, but not limited to, personal identification details, business operational details, and adherence to legal standards set by the Maryland Lottery and Gaming Control Agency. The form serves as a crucial first step in a meticulously regulated process, ensuring that all prospective lottery agents or vendors meet the state’s criteria for integrity, honesty, and financial responsibility. Moreover, it's a prerequisite for the legal sale of lottery tickets, operations of video lottery terminals, or involvement in any lottery-related activities within the state. The form, therefore, not only acts as a gateway for potential lottery agents but also as a tool for the state to maintain the credibility and trustworthiness of its lottery system. Through this licensing process, Maryland effectively balances the economic opportunities afforded by lottery sales with the need for responsible governance and oversight.
Sponsored Gaming Employee License Application
Maryland State Lottery Commission
MARYLAND STATE LOTTERY COMMISSION
VIDEO LOTTERY GAMING EMPLOYEE LICENSE APPLICATION
I.INDIVIDUALS REQUIRED TO OBTAIN A VIDEO LOTTERY GAMING EMPLOYEE LICENSE:
a.This application must be completed by an individual who has received at least a conditional offer of employment from a licensed facility operator, manufacturer or contractor as a video lottery employee, and whose duties relate or will relate to the operation of a facility, and who performs or supervises or will perform or supervise the performance of: (1) operating, servicing, or maintaining a video lottery terminal or associated equipment; (2) accounting, maintaining, or auditing a facility’s financial records; (3) counting or processing video lottery terminal revenue; (4) conducting security or surveillance in or around a facility; (5) operating or maintaining a facility’s information systems; (6) is employed by a contractor or manufacturer, whose duties directly relate to the repair, service or distribution of a video lottery terminal and associated equipment, or is otherwise required to be present on a facility’s gaming floor or in a restricted area of a facility; or (7) is otherwise required by the Commission to be licensed as a gaming employee. Examples of gaming employees may include, but are not limited to: booth operators, slot machine mechanics, count room employee, cage employee, security and surveillance personnel, auditing and accounting employees, or information technology employees.
b.An individual who is employed by licensee described above whose duties will be other than the duties described in (a) above are not required to obtain a gaming employee license. Those individuals are required to obtain a non-gaming license.
II.COMPLETING THIS FORM:
Sponsoring Licensee’s Responsibilities
a.This form is to be used only when a holder of a Maryland Video Lottery Manufacturer, Operator or Contractor Gaming License (sponsored licensee) makes application for an employee applicant who has been offered a position within the sponsored licensee business.
b.The form will be filled out by the applicant employee not the sponsored licensee. The sponsored licensee is responsible for completing the Certification of Sponsored Licensee at the end of this application.
c.The form must be submitted to the Commission by the Sponsored Licensee not the applicant employee.
Applicant Employee’s Responsibilities
d.You are to complete this form and submit it to the sponsored licensee for submission to the Commission.
e.You must make accurate statements and include all material facts. Any misrepresentation, or the failure to provide requested information, may result in the denial of your application.
f.Read each question carefully prior to answering. Answer every question completely. Do not leave blank spaces. If a question does not apply to you or you have nothing to disclose, indicate “Does Not Apply” in response to that question. Failure to provide a response to every question could result in the denial of your application.
g.If the space available is insufficient to respond to a question, supply the required information on an attachment page and clearly identify which question you are answering.
h.If you make any modification to the pre-printed questions or information contained in this form, your application may be denied. Once your application is submitted, it becomes the property of the Maryland State Lottery Agency and will not be returned.
III. BE SURE:
a.You sign the Statement and Authorization at the end of this form in the presence of a notary.
b.You retain a completed copy of your application for your own records.
IV. PHOTOGRAPH AND FINGERPRINTS
VLT Form 2003 (Rev July 21,2011)
Page 2 of 14
Initials
a.You will be required to have your photograph taken when your application is made.
b.You will be required to submit fingerprints upon application.
V.NOTICES
a.A Maryland gaming license is a privilege. The burden of proving and maintaining qualifications to receive and hold a gaming employee license is at all times on the applicant.
b.Any false statement made in this application will reflect on your character and may result in the denial of your application or, if you receive a license based on a false statement, may result in suspension or revocation of your license.
c.When the Commission completes its background investigation and you are found qualified for a Maryland license this license will automatically convert to a video lottery employee gaming license. Should you not be found qualified your sponsored gaming employee license will become the subject of revocation and suspension proceedings before the Commission.
NOTE: AN APPLICATION THAT HAS BEEN ACCEPTED FOR FILING AND ALL RELATED MATERIALS SUBMITTED TO THE COMMISSION SHALL BECOME THE PROPERTY OF THE COMMISSION AND WILL NOT BE RETURNED TO THE APPLICANT.
APPLICATION AND REGISTRATION FEES
1.
Application fee
$ 250.00
2.
Finger print processing fee
$ 37.25
3.
License fee
$ 150.00
4.
Initial term
3 Year
5.
Renewal fee
$150.00
6.
Renewal term
Note: License, Application & Fingerprint fees are due at the time of application. They are
non-refundable. You may wire transfer your payment or mail it to the following address:
DO NOT MAIL APPLICATION AND PAYMENT TOGETHER!!!
Mail payment to:
Maryland State Lottery Agency
Attn: Support Services
1800 Washington Blvd, Suite 330
Baltimore, Maryland 21230
Mail the application to the same address, except: Attn: VLT Licensing Division.
PAYMENT FORM: MUST be sent as a certified/bank check or money order.
Page 3 of 14
Name of Gaming Licensee:
(You must have an offer to work from a Licensee :)
Type of Licensee
Operator
Manufacturer
Contractor
Position Applicant is Applying for:
Last Name
NAME AND ADDRESS
Suffix(Jr.. Sr., etc.)
First Name
Middle Name
Maiden Name
Date of Birth
Address Line 1
Address Line 2
P. O. Box
City
County
State/Province
Zip Code
Country
5. Email Address
6. Home Phone
7. Cell Phone
MAILING ADDRESS (If different from above)
8. Address Line 1
Email Address
Home Phone
Cell
DESCRIPTIVE INFORMATION
9.
Height
10. Weight
11.
Social Security Number
12. Driver’s License
FT
IN
lbs
State Issued:
13.
Do you have any tattoos, scars or distinguishing marks?
If yes,
14.
» IARITAL STATUS:
describe in detail:
SINGLE
MARRIED
15.
PLACE OF BIRTH:
SEPARATED
DIVORCED
City/Town
WIDOWED
DOMESTIC PARTNER
16.
Name of Spouse
17.
Spouse’s Maiden Name or
18. spouse
19.
Spouse’s Social Security' Number
AKA
DOB
20.
HAIR COLOR
21.
EYE COLOR
22.
SEX
23.
RACE*
Are y ou of Hispanic/Latino origin?
Yes
No
(BK)Black
(BR) Brown
(BK) Black
(M) Male
Caucasian
Black/African American
(BD) Blonde
(RD) Red
(HZ) Hazel
(BL) Blue
(F) Female
Native Hawaiian/Pacific Islander
Asian
(GY) Gray
(WH) White
(GR) Green
American Indian/Alaska Native О Other:
(BA) Bald
♦ Multiracial respondents may select all applicable racial
categories.
LIST ANY OTHER NAME OR NAMES YOU HAVE BEEN KNOWN BY (INCLUDE ALIASES. NICKNAMES. MARRIED NAMES)
24.Have you been known by any other name or names? О YES О NO If YES, list the additional names below and specify dates for use for each. Include maiden name, aliases, nicknames or any other names used.
LAST NAME
FIRST NAME
MIDDLE NAME
SUFFIX
FROM
TO
DATE
VLT Form 2003 (Rev July 21, 2011)
Page 4 of 14
25.
Are you a United States citizen?
YES
NO
If NO, complete the following:
a.
Country of Citizenship:
Name and Address of sponsor
upon your arrival:
b.
If a naturalized citizen complete:
C.I.S. Registration Number:
2.Date Granted:
3.Court:
4.City/State of Court:
5.Certificate Number:
c. If you are a legally authorized Permanent Resident Alien, provide the “A" number from your Permanent Resident Card:
Card Number:
(Attach a color copy front and back)
d.If you do not posses a Permanent Resident Card but are authorized to work in the United States, please describe the U. S. Work Visa that you possess and provide the Visa number:
Description of Authorization:
VISA #:
26. Have you ever been issued a passport?
If, yes please complete the following:
Passport Number
Country of Issue
Place Issued
Date Issued
Expiration Date
DEPENDENTS
27.In the chart below, list the names of all your children, stepchildren and adopted children and the amount of support, if dependent. Also, list all other persons who you are supportin g or contributing to the support of, and provide the amount of support.
Name of Children/Dependent
Amount of
Present Address of
Support
Children/Dependents
Page 5 of 14
RESIDENCE
28.Beginning with your current residence(s) and working backwards, complete the following information for each place where you have lived (including residences while attending college or while in the military service) during the past ten (10) years or since the age Of 18, whichever is less. If additional space is needed, attach a separate sheet making
certain to indicate the question number.
Dates
Address
Own
Name, address & telephone no. of mortgage
From:
To:
(no, street, apt. #, City/town, state/province, zip
Or
company or landlord, if any
(Mo/Yr)
code
Rent
EDUCATION
29.Beginning with your highest level of education and working backwards complete the information listed below with respect to each school, college, graduate or postgraduate school you have attended, if additional space is needed,
attach a separate sheet making certain to indicate the question number.
Name and Address of
Description of
List any Degree
Graduated
School, Training program, etc.
Educational Program
or Certification
Yes/No
Page 6 of 14
EMPLOYMENT
30.Beginning with your present job and working backwards, list below all periods of employment for the past ten years or from age 18, whichever is less. Give dates of any unemployment between jobs in proper sequence. Include all part-time and full-time employment and anv military service. For any casino, horse racinq or qaminq related employment, please list your license number under “Title.” (If additional space is needed, attach a separate
sheet making certain to indicate the question number.) Have you been in the Military?
Yes E)No If yes, list regardless of time.
Name, Address and telephone Number
Title/Position Held and
Supervisor’s
Reason for leaving/
(Mo/Yr
of Employer(s)
Description of Duties
Name
Compensation at
Departure
31. Have you ever been discharged or asked to resign from a job?
Yes If Yes, complete below.
Employer’s Name & Address
Date of Discharge or
Reason for Leaving
Resignation
Page 7 of 14
CIVIL, CRIMINAL & INVESTIGATORY PROCEEDINGS
Prior to answering this question, carefully review the definitions and instructions which follow .
DEFINITIONS: For purposes of this question:
A.“Arrest” includes any time that you were stopped by any law enforcement officer and advised that you were under arrest, detained, held for questioning or were requested by a law enforcement officer to come to a law enforcement office or facility and answer questions. “Arrest” also includes any circumstances in which you were taken into custody by any law enforcement officer, fingerprinted, detained in any jail or detention center, or otherwise been the subject of a court order to appear in a judicial proceeding in which you were accused of a “crime or offense” as defined in subsection C.
B.“Charge” includes any indictment, complaint, information, summons, or other notice of the alleged commission of any “offense.”
C.“Offense” includes all felonies, misdemeanors, and summary offenses that may have required you to appear before any municipal, state, or federal grand jury, court, or any other judicial tribunal except juvenile court. “Offense” also includes all driving-related charges or offenses which carry any period of incarceration.
INSTRUCTIONS:
1.Answ er “YES” and provide all information to the best of your ability EVEN IF:
A.You did not commit the offense charged;
B.The charges were dismissed or downgraded to a lesser charge;
C.You completed a pretrial intervention or other rehabilitation or diversionary program;
D.You were not convicted;
E.You did not serve any time in a correctional facility;
F.The charges or offenses happened a long time ago; or
G.You were not arrested for the charge.
2.Answer “NO” if:
a)You have never been charged with or arrested for any crime or offense;
b)Your were arrested or charged when you were under eighteen (18) years of age and your arrest or charge, including any sentence that a court imposed, was adjudicated entirely in juvenile court;
c)The records of the charge or arrest have been expunged pursuant to an order of court or
otherwise sealed by a court of competent jurisdiction.
I I 1 have read and understand the definitions and instructions
IMPORTANT
Maryland tvi/Z make inquiries to establish w hether the identified individuals have had any involvement with law
enforcement agencies.
Failure to disclose anv such involvement w ill be taken into account in
assessing the Applicant’s character, honesty and integrity. Do you understand?: 1 1
32. Have you ever been arrested or charged w ith any offense in any jurisdiction?
1 1 YES
1 1 NO
If yes, complete the follow ing chart:
Disposition
Nature of Charge or
Date of Charge or
(Convicted,
Law Enforcement
Sentence
Offense/Location of Where
Acquitted,
Offense
Agency or Court
(if any)
Incident Occurred
Dismissed, Pending,
Involved
Pardoned, etc.)
VLTForm 2003 (Rev July 21,2011)
Page 8 of 14
33.To the best of your knowledge, has a criminal indictment, information or complaint ever been filed or returned against you, or named you as an unindicted party or unindicted co-conspirator in any criminal proceeding in any
jurisdiction?
'
Dyes Dno
Name and Address of Governmental
Nature of Proceeding
Outcome/Disposition
Date
Agency/Organization Involved
34.To the best of your knowledge, have you ever been the subject of an investigation conducted by any governmental agency/organization, court, commission, committee, grand jury or investigatory body (local, state, county, provincial, federal, national, etc.) other than in connection with a traffic summons?
YES ONO
Ifyes^complete the following chart:
Name and Address of Court or
Was
Date on which
Approximate Time Period of
Testimony
Other Agency
or Investigation
Investigation
Given?
was Given
35. Have you ever received a pardon, or has any government agency/organization dismissed, suspended or deferred any
criminal investigation or prosecution against you for any criminal offense?
О YES I I NO
If yes, complete the following chart:
Date of Pardon, Dismissal,
Type of Action Taken
Name and Address of Government Agency/Organization
Suspension or Deferral
Granting Pardon, Dismissal, Suspension or Deferral
36.Have you or any business entity with which you are or were associated, ever filed under bankruptcy, been petitioned into bankruptcy or made a proposal under any bankruptcy or insolvency law in any jurisdiction?
If yes, complete below:
Date Filed
Docket #
Name & Address of Court
Date Judgment
Entered.
Page 9 of 14
After deciding to apply for a Maryland Lottery License, it's essential to accurately complete the submission process. This License will permit you to legally operate games of chance in the state, contributing to your business's growth and the local community. Given the importance of this application, paying close attention to the details and ensuring the accuracy of your information is crucial. Here’s a step-by-step guide to filling out the Maryland Lottery License form to streamline your application process.
After submitting the form, the application will go through a review process. During this time, the Maryland Lottery and Gaming Control Agency may request additional documentation or clarification to ensure compliance with state regulations. Successful applicants will receive their Lottery License, permitting them to operate games of chance legally within Maryland. It's important to note any specific conditions or restrictions attached to the License and adhere to them to maintain good standing.
The Maryland Lottery License Form is a document required by the Maryland Lottery and Gaming Control Agency for businesses seeking to sell lottery tickets or operate lottery-related gaming activities in the state. This form is the initial step in obtaining the necessary authorization to participate in the lottery business, ensuring compliance with state regulations.
Any business entity, including sole proprietors, partnerships, and corporations, interested in selling Maryland lottery tickets or offering lottery gaming must complete the Maryland Lottery License Form. This includes convenience stores, gas stations, and other retail locations wanting to add lottery sales to their offerings.
To complete the Maryland Lottery License Form, the following information is typically required:
The completed Maryland Lottery License Form can be submitted either online through the Maryland Lottery and Gaming Control Agency's website or by mailing a hard copy to their office. It's important to ensure that all required sections are completed and any necessary supporting documents are included to avoid delays in processing.
Yes, there is an application fee associated with the Maryland Lottery License Form. The specific amount varies depending on the type of license you are applying for and other factors. The Maryland Lottery and Gaming Control Agency's website provides the most current fee schedule. Note that this fee is non-refundable, even if the application is denied.
The processing time for a Maryland Lottery License Form can vary but typically takes several weeks from the date of submission. This period allows the Maryland Lottery and Gaming Control Agency to review the application, perform necessary background checks, and ensure the applicant meets all regulatory requirements.
Lottery licenses in Maryland are specific to both the owner and the location. If there is a change in ownership or if the business is moved to a new location, a new Maryland Lottery License Form must be submitted and approved before lottery ticket sales can continue.
If your Maryland Lottery License application is denied, the Maryland Lottery and Gaming Control Agency will provide specific reasons for the denial. Applicants have the opportunity to address any deficiencies noted in the denial letter and reapply. It is advisable to carefully review the feedback provided and make all necessary adjustments before submitting a new application.
For more detailed information about obtaining a Maryland Lottery License, including up-to-date application forms, fee schedules, and submission guidelines, visit the official Maryland Lottery and Gaming Control Agency website. Additionally, you can contact their office directly for personal assistance and clarification on the application process.
When filling out the Maryland Lottery License form, people often make several common mistakes. These errors can lead to delays in the processing of the application or even its outright rejection. It's crucial to be mindful of these pitfalls to ensure a smooth application process. Here are four frequently observed mistakes:
Not double-checking personal information: Applicants frequently enter incorrect details such as their Social Security Number, date of birth, or misspell their own names. Precision with personal information is critical for the verification process.
Skipping sections: Some sections of the form might not seem relevant at first glance, leading applicants to leave them blank. However, every section must be completed unless specifically indicated as optional. Incomplete forms are a common reason for delays.
Signature and date issues: It is not uncommon for applicants to forget to sign the form or date it properly. An unsigned or undated form is considered invalid and will not be processed.
Incorrect or outdated form version: The state may update the application form periodically. Applicants sometimes use an outdated version of the form, which may not be accepted. It's important to always use the most current version available from the official website.
To avoid these mistakes, applicants are advised to review their entire application thoroughly before submission. Additionally, instructions provided with the form should be read carefully, and the latest version of the form should always be used. By being attentive to these details, applicants are more likely to achieve a successful application for the Maryland Lottery License.
When applying for a Maryland Lottery License, applicants are required to submit additional forms and documents to ensure compliance with state regulations. These documents help in establishing the applicant's legality, identity, and capability to manage the responsibilities associated with running a lottery. Below is a list of documents and forms often required alongside the Maryland Lottery License form.
Collectively, these documents play a critical role in the processing of a Maryland Lottery License application. By submitting a complete and accurate package, applicants can facilitate a smoother review process, ultimately expediting the approval of their license to operate a lottery.
The Maryland Lottery License form is similar to other regulatory licensing applications, particularly those required for operating businesses within specific industries that are tightly regulated due to their nature. The forms share several common features, including the requirement for detailed personal information, business operational details, and a history of compliance with local and federal laws. They are designed to ensure that applicants meet the standards required to operate within the jurisdiction, protecting the interests of the public and ensuring the integrity of the business sector involved.
One such document is the Alcohol Beverage License application. Like the Maryland Lottery License form, the Alcohol Beverage License application requires comprehensive information about the business owners, the premises where the alcohol will be sold or served, and a detailed account of the security measures that will be in place to comply with state laws. Both forms scrutinize the applicant’s background, including any criminal history, to assess their suitability for running a business within industries that have a significant impact on public welfare and safety.
Another similar document is the Business License application issued by local municipalities. This form often necessitates providing detailed information about the business, including its legal structure, physical location, and the nature of the goods or services offered. The primary aim is to ensure that businesses operate legally, safely, and within the bounds of local regulations, akin to the goals of the Maryland Lottery License form. There is also a focus on ensuring compliance with zoning laws, fire safety regulations, and health codes, mirroring the comprehensive review process of lottery and alcohol license applications.
The Gaming Operator License form, required for casinos and similar establishments, shares a close resemblance with the Maryland Lottery License form in its aim to regulate entities engaged in gambling activities. This form demands detailed financial information, plans for adhering to gaming laws, and strategies for promoting responsible gambling. Both documents are integral to the regulation of gambling activities, emphasizing the suitability and responsibility of the operators, as well as the protection of participants and the prevention of fraud.
When embarking on the process of filling out the Maryland Lottery License form, individuals should make sure they approach this important task with care and attention. Accordingly, there are several dos and don’ts that can guide applicants through the process smoothly, ensuring they provide accurate and thorough information. Here is a list of key recommendations to follow:
In conclusion, by following these recommendations, applicants can navigate the process of completing the Maryland Lottery License form with greater confidence and efficiency. Attention to detail and adherence to guidelines play a crucial role in the successful submission of any formal application.
Many people have misunderstandings about the Maryland Lottery License form. Let's clear up some of those misconceptions to help everyone understand it better.
One common misconception is that the form is only necessary for large businesses. In reality, any establishment wishing to sell lottery tickets, whether it's a small convenience store or a large supermarket, needs to complete this form. The size of the business doesn't influence the requirement for licensure.
Some believe that completing the Maryland Lottery License form is a one-time event. However, this isn't the case. The license must be renewed periodically to ensure compliance with state regulations and to continue selling lottery products. The renewal process ensures that businesses follow current laws and maintain good standing.
Another misconception is that the form is overly complicated and requires legal expertise to complete. While it's comprehensive, the form is designed to be fillable by the business owner or a designated manager without necessitating professional legal assistance. Instructions are provided to guide applicants through the process.
There's also a belief that approval is guaranteed once the form is submitted. Unfortunately, this isn't true. The Maryland Lottery and Gaming Control Agency reviews each application to ensure the applicant meets all requirements. Not all applications are approved, depending on factors such as the applicant's criminal background or financial stability.
Lastly, many think that the Maryland Lottery License form and obtaining the license doesn't cost anything. While it's true that the state aims to make the process accessible, there are fees associated with both the application and renewal of the license. These fees cover administrative costs and contribute to the regulatory efforts of the state to maintain the integrity of lottery sales.
For individuals or entities aiming to delve into the regulated landscape of lottery sales in Maryland, understanding the nuances of filling out and using the Maryland Lottery License form is paramount. This document serves as a gateway to becoming a licensed lottery retailer and implicates adherence to state gambling regulations. Below are key takeaways that should guide applicants through this process, ensuring compliance and clarity.
Successfully navigating the application process and maintaining a Maryland Lottery License demands thorough preparation, attention to detail, and an ongoing commitment to compliance. By adhering to these key takeaways, applicants and license holders alike can foster a responsible and profitable lottery retail environment.
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