Dpssp 0077a 2025

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The document is an application form from the Louisiana Gaming Control Board, specifically for individuals associated with manufacturers of gaming equipment or gaming suppliers. It outlines the requirements for personal history and financial disclosure necessary to obtain a gaming permit. The form includes sections for personal information, residences, family details, education, military service, criminal history, employment history, ownership interests, political activity, business associations, and financial status. It emphasizes the importance of accuracy in disclosures and the legal consequences of providing false information.

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Click ‘Get Form’ to open the dpssp 0077a in the editor.
Begin by filling out Section A, Personal Information. Enter your last name, first name, and middle name. Ensure you provide your Social Security Number and Driver’s License Number accurately.
In Section B, Residences, list all addresses where you have lived in the past ten years. Be thorough and include dates for each residence.
Proceed to Section C, Family Information. Provide details about your current and former spouse(s), including their names and dates of marriage.
Complete Sections D through L as applicable, ensuring that all questions are answered completely. If a question does not apply, write 'Does Not Apply.'
Once all sections are filled out, sign the application and initial each page to attest to the accuracy of your information.
Finally, submit the completed application along with any required documents via mail to the appropriate Louisiana State Police Gaming Enforcement Division office.

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