Arizona Form 830. (Bingo) Affidavit - azdor 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Licensee’s Name and License Number at the top of the form.
3. Select your Position by checking the appropriate box: Manager, Supervisor, Proceed Coordinator, or Assistant.
4. Fill in your Affiant’s Name, Social Security Number (optional), Date of Birth, Address, City, State, ZIP Code, Home Phone No., and Work Phone No.
5. If you are part of a qualified organization, indicate 'Yes' or 'No' for being a Member and provide the Date Joined if applicable.
6. Answer whether you have an affidavit on file for any other licensee by selecting 'Yes' or 'No', and list any license numbers if applicable.
7. Finally, sign and date the affidavit at the bottom to confirm that all information is accurate and complete.

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