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Louisiana gaming license application

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The document is an application form from the Louisiana Gaming Control Board for individuals associated with non-gaming supplier permit applicants. It outlines the requirements for personal history and financial disclosure, emphasizing the applicant's responsibility to provide accurate information and the consequences of false statements. The form includes sections for personal information, residences, family details, military service, criminal history, and licensing information. It also contains legal notices regarding the privilege of holding a gaming permit and the need for compliance with state laws.

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Click ‘Get Form’ to open the dpssp gaming application in the editor.
Begin by filling out Section A, Personal Information. Enter your last name, first name, and middle name. Include any maiden names or aliases, your Social Security Number, and driver’s license details.
Proceed to Section B, Residences. List all addresses where you have lived in the past ten years, ensuring accuracy for each entry.
In Section C, Family Information, provide details about your current marital status and spouse's information if applicable. Include prior marriage details as necessary.
Complete Section D regarding Military Service Information by indicating any military service and related inquiries.
Fill out Section E on Criminal, Investigatory and Civil Proceedings. Be thorough in disclosing any legal issues you may have faced.
Finalize by signing the application in Section G and attaching a recent photograph as required.

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