Gaming Related Gaming Service Provider License Applications


Initial Application Forms


Application Renewal Forms

Please be advised that this gaming related gaming service provider form is now fillable. The forms will allow you to type the information requested into the fillable portions of the forms. After you complete the fillable portions of the application, you must print a copy of the application and initial the bottom of each page in ink. There will also be several pages that need to be notarized and signed. These pages are not fillable and must be completed in ink.

Please follow the instructions below:

  1. Open the named file below.
  2. Save the file to your PC.
  3. Complete the form by entering data into the grey highlighted areas of the application.
  4. Once the form is complete, print the application, initial each page in ink and complete each signature page in ink.

PDF Gaming Related Gaming Service Provider Application and Disclosure Information Form (fillable)

NOTE: If you do not wish to fill out the form on the computer, print the form out first, then fill it in by hand, just as if it were a regular form. This is also true for printing out extra copies of individual pages or schedules.