INSTRUCTIONS: ARIZONA APPLICATION FOR BINGO LICENSE (Form 71-1010)

To apply for an Arizona bingo license, file a form 71-1010. This document can be obtained from the website of the Arizona Department of Revenue.

Arizona Application For Bingo License 71-1010 Step 1: In boxes 1 through 4b, enter your name, telephone number, administrative office location and mailing address.

Arizona Application For Bingo License 71-1010 Step 2: Lines 5 through 11 should only be completed with check marks by Class B and Class C license applicants.

Arizona Application For Bingo License 71-1010 Step 3: On line 12, give the name, title and address of one or two persons who will serve as managers.

Arizona Application For Bingo License 71-1010 Step 4: On line 13, give the name, title and address of the person designated as proceeds coordinator.

Arizona Application For Bingo License 71-1010 Step 5: On line 14, enter the names, titles and address of up to four people who will serve as supervisors.

Arizona Application For Bingo License 71-1010 Step 6: On line 15, enter the names of up to eight people who will serve as assistants.

Arizona Application For Bingo License 71-1010 Step 7: On line 16, give the street address of the physical location where bingo will be played.

Arizona Application For Bingo License 71-1010 Step 8: On line 17, enter the hours during which bingo will be played on each line.

Arizona Application For Bingo License 71-1010 Step 9: On line 18, list the dates of proposed game cancellation, if any.

Arizona Application For Bingo License 71-1010 Step 10: On line 19, provide all information requested about the type of premises where bingo will be played.

Arizona Application For Bingo License 71-1010 Step 11: On line 20, list up to two bingo licensees who are or will be conducting bingo in the same premises as you or those who are located within 1,000 feet of your premises.

Arizona Application For Bingo License 71-1010 Step 12: In section 21, document your expected bingo expenses as instructed.

Arizona Application For Bingo License 71-1010 Step 13: In section 22, briefly state the specific projected use of net proceeds from games of bingo.

Arizona Application For Bingo License 71-1010 Step 14: In the last section, print your name, enter your signature, the date and your title.