RETAILER APPLICATION - Louisiana Lottery Corporation 2026

1. Click ‘Get Form’ to open the RETAILER APPLICATION in the editor.
2. Begin by entering your BUSINESS NAME and ADDRESS OF SALES LOCATION clearly in the designated fields. Ensure all information is typed or printed in black ink.
3. Fill in your CONTACT NAME & TITLE, along with the BUSINESS PHONE NUMBER and MAILING ADDRESS if it differs from the sales location.
4. Indicate whether you operate under a business trade name (d.b.a.) and provide your FEDERAL I.D. NUMBER and LOUISIANA TAXPAYER IDENTIFICATION NUMBER.
5. Select your TYPE OF BUSINESS from the provided options, ensuring to check all applicable boxes.
6. Answer all questions regarding tax payments, felony convictions, and bankruptcy truthfully. Attach explanations for any 'YES' responses.
7. Sign and date the application at the bottom, certifying that all information is accurate before submitting it through our platform.

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