Gaming Service Provider License Applications

 

 

 

 

 

Please be advised that the gaming service provider forms are 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 application 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 Publicly Traded Corporation Authorization 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.

Please be advised that the gaming service provider forms are 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 application 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 Service Provider Certification Application and Disclosure Information Renewal 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.

Please be advised that the gaming service provider forms are 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 application 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 Service Provider Certification Renewal Form Private Holding Company (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.

Please be advised that the gaming service provider forms are 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 application 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 Pennsylvania Personal History Disclosure Renewal 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.

Please be advised that the gaming service provider forms are 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 application 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 Sponsored Gaming Service Provider Registration Renewal 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.

Please be advised that the gaming service provider forms are 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 application 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 Unsponsored Gaming Service Provider Registration Renewal 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.