State of Nevada

NEVADA GAMING COMMISSION
and
STATE GAMING CONTROL BOARD

Seal of Nevada

Agency Forms & Applications


Note:  Documents, forms and applications on this site are stored as MS Word, MS Excel, or Adobe Acrobat files.  To download Adobe's Acrobat Reader or Microsoft's Word Viewer free of charge, click  here.


Table of Contents
Administration Division
Audit Division
Enforcement Division
Investigations Division
Tax and License Division
Technology Division


Administration Division
Publications
List of Publications PDF
Gaming Control Board Application for Employment PDF


Audit Division
New Applicants
New Applicant Pre-Opening Checklist for Group I Licensees
    Revised 06/09
PDF

Internal Control Systems
NGC Regulation 6.090 Written System of Internal Control Policies PDF
Internal Control System Submission Summary Form PDF

Race Book and/or Sports Pool
Application Instructions for a Race Book and/or Sports Pool
    Revised 12/07
PDF
Race Book-Sports Pool Questionnaire PDF
Book Wagering Report Instructions PDF
Book Wagering Report Form PDF
Listed Patron Approval PDF
Model Reserve Agreements
     Agreement Example
     Bond Example
PDF
PDF
PDF
Registration of Race Book & Sports Pool Employees PDF
Sample Compliance Report PDF
Suspicious Wager Report Instructions PDF
Suspicious Wager Report Form PDF

Regulation 6.130
Count Personnel Reporting Form PDF
Drop and Count Time Form for Group I Licensees WORD
Regulation 6.130 Count - Removal Report Instructions   (Rev. 07/11) PDF

Regulation 6.150 Bankroll Formula and Information
Bankroll Formula Excel
Bankroll Formula - Restricted licensees Excel
Bankroll Instructions PDF
Overview Document PDF

Regulation 8.130 Transactions
Transaction Reporting Form WORD
Instructions for Filing Forms PDF
Supplemental Information Form WORD
Instructions for Filing Supplemental Information Forms PDF


Enforcement Division

3rd Party Registration
ENF-120 3rd Party Registration
    (Rev. 01/11)
PDF WORD

Charitable Gaming Applications
Charitable Bingo Game Application Information (ENF-114A)
   (Rev. 08/11)
PDF  
Charitable Bingo Application for Approval or Registration
    (Rev. 02/11)
PDF WORD
Charitable Gaming Application for Board Approval
    (Rev. 02/11)
PDF WORD
Charitable Lotteries Application for Approval or Registration (ENF-115)
    (Rev. 03/11)
PDF WORD

Chips and Tokens
Chip and Token Redemption
    Revised 02/11
PDF WORD
Chip and Token Destruction Plan
    Revised 02/11
PDF WORD
Record of Destruction of Chips and Tokens
    Revised 02/11
PDF WORD

Gaming Salon
Gaming Salon Notification (ENF-110) PDF WORD

Gaming Device Transactions
Private Sale Application 14.330 PDF
Regulation 14.180 Application - Licensed Manufacturers and Distributors
Instructions
Forms
PDF
PDF
Regulation 14.190/14.180 Application - Other than Distributor
Instructions
Forms
PDF
PDF

New Games
New Game Evaluation Procedure
    Revised 09/10
PDF  
Request to Release Information
    Revised 05/04
PDF WORD
Release of All Claims
    Revised 05/04
PDF WORD
Affidavit of Full Disclosure
    Revised 05/04
PDF WORD
Personal History Record
    Revised 02/09
PDF WORD
List of Nevada Approved Gambling Games
    Revised 02/01/12
PDF EXCEL
Game Variation/Modification of an Approved Game Format
    Revised 06/10
PDF  

Horse Racing
License Application (Horse Racing)
    Enf-84 Revised 07/11
PDF  

Race Book and/or Sports Pool
Application Instructions for a Race Book and/or Sports Pool
    Revised 12/07
PDF  
Race Book-Sports Pool Questionnaire PDF  
Book Wagering Report Instructions PDF  
Book Wagering Report Form PDF  
Listed Patron Approval PDF  
Model Reserve Agreements
     Agreement Example
     Bond Example
PDF
PDF
PDF
 
Registration of Race Book & Sports Pool Employees PDF  
Request to Offer Wagers on Event other than a Horse Race, Greyhound Race, or Athletic Sporting Event - Regulation 22.120
    Enf-121 03/11
PDF WORD
Sample Compliance Report PDF  
Suspicious Wager Report Instructions PDF  
Suspicious Wager Report Form PDF  

Statements  
Voluntary Statement PDF WORD
Voluntary Statement Continuation PDF WORD


Investigations Division
  
Instructions
For Nonrestricted Gaming License
    Revised 10/11
PDF
For Restricted Gaming License
    Revised 10/11
PDF
For Nonrestricted Gaming License as a Key Employee
    Revised 10/11
PDF
For Restricted Gaming License as a Key Employee
    Revised 10/11
PDF
Instructions to Applicants for a Manufacturer and/or Distributor License
    Revised 10/11
PDF

Requesting Licensing to Conduct Pari-Mutuel Wagering
    Revised 02/06

PDF

For Approval to Participate in Pari-Mutuel Commissions
    Revised 01/11
PDF
For Gaming Salon
    Revised 06/11
PDF
Requesting Licensing as an Information Service
    Revised 10/11
PDF
Grant of Option Instructions
    Revised 01/11
PDF
Instructions to Applicants for a License to Conduct Racing
    Revised 10/11
PDF
Instructions to Applicants Requesting a Preliminary Determination of a Location's Suitability for the Conduct of Gaming
    Revised 02/06
PDF
Instructions to Applicants for a Disseminator License
    Revised 10/11
PDF
Instructions to Applicants as an Operator of a Call Center
    Revised 10/11
PDF
Instructions to Applicants Requesting Enrollment as an Agent Pursuant to NGC Regulation 10
    Revised 06/11
PDF
Instructions to Applicants for Registration as a Minority Interest Holder
    Revised 12/11
PDF

Forms and Applications
Form 1  Application For a Nevada Gaming License
    Revised 01/11
PDF WORD
Form 1R  Application for Registration as a Minority Equity Interest Holder of a Licensee/Holding Company
    Revised 12/11
PDF WORD
Form 2 Application For Approval by Corporation/Partnership/ Limited Liability Company
    Revised 01/11
PDF WORD
Form 2R Application For Registration as a Minority Equity Interest Holder by a Corporation/Partnership/Limited Liability Company
    Revised 01/12
PDF WORD
Form 3  Application For Registration by Holding Company/ Intermediary Company
    Revised 01/11
PDF WORD
Form 4  Personal History Record (For Restricted Applications only)
    Revised 12/11
PDF WORD
Form 4R  Personal History Record (For a Minority Equity Interest Holder)
    Revised 12/11
PDF WORD
Form 5  Personal Financial Questionnaire (PFQ)
    Revised 12/11
PDF WORD
Form 5R  Personal Financial Questionnaire (PFQ - For a Minority Equity Interest Holder)
    Revised 12/11
PDF WORD
Form 6  Statement of Pre-opening Cash/First Years Cash Flow PDF EXCEL
Form 7  Multi Jurisdictional Personal History Disclosure Form (Nonrestricted Applications only)
    Revised 12/11
PDF WORD
Form 7A Nevada Supplemental Personal History Disclosure Form (Nonrestricted Applications only)
    Revised 12/11
PDF WORD
Form 8 Application to Conduct Racing by Corporation/Partnership/Limited Liability Company
    Revised 01/11
PDF WORD
Form 9  Application to Conduct Racing (by an Individual)
    Revised 01/11
PDF WORD
Form 10  Affidavit of Full Disclosure
    Revised 05/04
PDF WORD
Form 13  Application to Conduct Pari-Mutuel Wagering
    Revised 01/11
PDF WORD
Form 14  Application for Approval from Nevada Gaming Authorities
    Revised 01/11
PDF WORD
Form 15  Location/Landlord Information Sheet     
    Revised 10/11
  Diagram Example – Convenience Store - PDF
  Diagram Example – Bar/Tavern - PDF
PDF WORD
Form 16 Due Diligence Form Pursuant to NGC Regulation 5.011(5) PDF WORD  
Form 17  Release and Indemnity of All Claims
    Revised 05/04
PDF WORD
Form 18  Request to Release Information
    Revised 05/04
PDF WORD
Form 19  Application for Enrollment as an Agent
    Revised 05/11
PDF WORD
Form 20  Source and Application of Funds (Application for Restricted Gaming License)
    Revised 07/07
PDF WORD
Form 21  Application to Transfer Interest
    Revised 03/08
PDF WORD
Form 26  Registration of Call Center Employees
    Revised 02/06
PDF WORD
Form 27  3.015(2) Additional Requirements for Restricted Applications
    Revised 10/11
PDF WORD
Form 28  Electronic Fingerprint Instruction Memo and Receipt     
    Revised 01/12
   Fingerprint Locations
PDF WORD

Independent Agent Registration/Reporting
Instructions for Registering as an IA
    Revised 01/12
    (Regulation 25)
PDF
Form JR-12 Personal History Record for Registering as an Independent Agent
    Revised 01/12

PDF

Form JR-12R Personal History Record - Registration Renewal
    Revised 01/12

PDF

Form 18-IA  Request to Release Information (Independent Agents)
    Revised 01/12
PDF
JR-08  Report of Arrangements
    Revised 01/12
PDF
JR-09  Quarterly Reporting (Regulation 25 Filing)
    Revised 09/04
PDF WORD
JR-10  Annual Report of Secondary Representatives (Regulation 25 Filing)
    Revised 01/12
PDF
JR-11  Irrevocable Appointment of Agent
    Revised 01/12
PDF

Key Employee Reporting (Reg 3.100)
Form 3.100  Key Employee Reporting (Excel Spreadsheet)
    Revised 09/11
Excel
Reg 3.100  Instructions for Assigning Standardized Job Codes to Employees PDF

Race Book and/or Sports Pool
Application Instructions for a Race Book and/or Sports Pool
    Revised 12/07
PDF
Race Book-Sports Pool Questionnaire PDF
Book Wagering Report Instructions PDF
Book Wagering Report Form PDF
Listed Patron Approval PDF
Model Reserve Agreements
     Agreement Example
     Bond Example
PDF
PDF
PDF
Registration of Race Book & Sports Pool Employees
     Revised 02/06
PDF WORD
Sample Compliance Report PDF
Suspicious Wager Report Instructions PDF
Suspicious Wager Report Form PDF


Regulation 5.200
Reg 5.200  Registration of International Gaming Salon Employees PDF


Foreign Gaming
Operator Forms
    Foreign Gaming Reporting Requirements Policy Statement
        Revised: 07-17-09
PDF
    FG-700  Notification Statement
        Revised: 07-17-09
WORD
    FG-710-1  Operation Statement
        Revised: 07-17-09
WORD
    FG-710-2  Annual Report
        Revised: 07-17-09
WORD
    FG-710-3  Quarterly Report
        Revised: 07-17-09
WORD
    FG-710-4  Termination Notice WORD
Participation Agreement Forms    
    FG-710-3 (PA)  Quarterly Report WORD

Publicly Traded Corporations
Reporting Requirements PDF
Official Forms Instructions - Forms for use by Publicly Traded Corporations
    Revised 03/06
PDF
PTC-1  Application
    Revised 03/06
PDF
Release of All Claims PDF
PTC-2  Application for Registration or for Amendment to Order of Registration
    Revised 03/06
PDF
PTC-110  Application for Approval of a Public Offering
    Revised 03/06
PDF
PTC-115  Application for a Continuous or Delayed Public Offering ("shell")
    Revised 09/06
PDF
PTC-200  Application for Approval of and Acquisition of Control
    Revised 03/06
PDF
PTC-250  Application for Approval of a Plan of Recapitalization
    Revised 03/06
PDF
PTC-260  Application for Approval of Exceptional Repurchase of Securities
    Revised 03/06
PDF
PTC-310  Application for Approval of a Proxy Statement or Information Statement
    Revised 03/06
PDF
PTC-320  Application for Approval of Listing on a Securities Exchange
    Revised 03/06
PDF
PTC-430  Application for Waiver of NGC Reg. 16.430 as an Institutional Investor
    Revised 03/06
PDF


Tax and License Division

Regulation 5.210(1) Transactions  
Nonrestricted Licensee Request for Administrative Approval to Charge a Fee for Admission PDF
   
Drop and Count Forms  
6.130.1(a)  Drop and Count Schedule    (Rev 09/13/11) PDF WORD
6.130.1(b)  Count Quarterly Personnel Report    (Rev 09/13/11) PDF WORD
Regulation 6.130 Count - Removal Report Instructions   (Rev. 07/11) PDF

Regulation 6.150 Bankroll Formulas  
Bankroll Formula Excel
Bankroll Formula - Restricted licensees Excel
Bankroll Formula Information Page Information
   
Regulation 8.130 Transactions  
Transaction Reporting Form PDF
Instructions for Filing Forms PDF
Supplemental Information Form PDF
Instructions for Filing Supplemental Information Forms PDF

New Applicants  
New Applicant Pre-Opening Checklist for Group II Licensees PDF

Tax Forms and Informational Filings
Filing Deadlines PDF  
License Fee & Tax Rate Schedule for Nonrestricted & Restricted Licensees PDF  
NGC-01  Monthly Gross Revenue Reports     (Rev 09/08/11) PDF EXCEL
NGC-02  Annual State License Fee Report Based on Number of Games to be Operated    (Rev 10/17/11) PDF EXCEL
NGC-02  Fee Schedule PDF  
NGC-04  Fiscal Year Report of Slot Machine Taxes     (Rev 09/08/11) PDF EXCEL
NGC-11  Live Entertainment Tax     (Rev 10/17/11) PDF EXCEL
NGC-12  Live Entertainment Tax - Restricted Licensees    (Rev 10/17/11) PDF EXCEL
NGC-13  Live Entertainment Tax Report  (Rev 10/17/11) PDF EXCEL
  Maximum Occupancy/Seating of At Least 7500  
NGC-14  Restricted Licensee Report of Quarterly State License Fees  (Rev 10/17/11) PDF EXCEL
NGC-15  Report of Quarterly State Gaming License Fees  (Rev 10/17/11) PDF EXCEL
NGC-15  Fee Schedule PDF  
NGC-16  Holiday or Special Event Application  (Rev 10/17/11) PDF EXCEL
NGC-17  Standard Financial Statement Filing Software
and Documentation
Download
NGC-17-a  Standard Financial Statement for Slot Machine Route Operator Licensees PDF EXCEL
NGC-18  Report of Quarterly Expired Slot Machine Wagering Vouchers and Payout Receipts  (Rev 11/15/11) PDF EXCEL
NGC-20  Racing Information Disseminators Monthly Report (informational form)   (Revised 08/11) PDF  
NGC-20-A  Racing Information Disseminators Monthly Report (tax form)  (Revised 08/11) PDF
NGC-21D  Distributer's License   (Revised 08/11) PDF
NGC-21M  Manufacturer's License   (Revised 08/11) PDF
NGC-21P  Pari-Mutuel System Operator's License   (Revised 08/11) PDF
NGC-25  Operator of a Slot Machine Route   (Revised 08/11) PDF
NGC-25I  Operator of Inter-Casino Linked System   (Revised 08/11) PDF
NGC-27  Information Service License Fee Report   (Revised 08/11) PDF
NGC-30  Monthly Gross Revenue Statistical Report
    Gaming Salon
PDF
NGC-31  Monthly Gross Revenue Statistical Report   (Revised 03/11) PDF EXCEL
NGC-31  Monthly Gross Revenue Statistical Report Instructions PDF
NGC-32  Track Handle and Win Report PDF
  NGC-32 Instructions PDF
NGC-36 Paper Form Filers:  
  NGC-36  Slot Route Operator Informational Report (Paper Copy) PDF
  NGC-36A Instructions and Summary Form for Paper Filers (Required) PDF
  Column by Column Instructions for NGC-36 Form PDF
  Location Listing
    Revised 01/10/2012
Excel
NGC-36 Electronic Filers:  
  NGC-36 Spreadsheet for Electronic Filing - Excel Excel
  NGC-36EIT Instructions and Summary Form for Electronic Filers (Required) PDF
  Column by Column Instructions for NGC-36 Form PDF
  Location Listing
    Revised 01/10/2012
Excel
   
NGC-PMT-1  Pari-Mutuel Wagering Tax   (Revised 08/11) PDF
   
ER101 Monthly Condensed Financial Statements PDF
   
Sample of Surety Bond for Gaming Establishment (updated 06/09) PDF


Technology Division

Associated Equipment
Approval Process for Associated Equipment
    Revised: 2/10/2010
PDF  
Associated Equipment Matrix
    Revised: 1/2010
PDF  
Manufacturer's Request for Review
    Revised: 11/29/2007
PDF  
Associated Equipment Feature Codes
    Added: 11/29/2007
PDF  
User's Request for Installation
    Revised: 11/29/2007
PDF  
Personal History Record PDF  
Form 18  Request to Release Information
    Revised 05/04
PDF WORD

Associated Equipment Review Checklists
Associated Equipment Manufacturer Submission Checklist PDF WORD
Bingo System AE Review Checklist PDF WORD
Computerized Keno System AE Review Checklist PDF WORD
ILS and Local Area Progressive AE Review Checklist PDF WORD
LET Point of Sale Systems AE Review Checklist PDF WORD
Race Sports and Pari-Mutuel AE Review Checklist PDF WORD
Slots AE Review Checklist PDF WORD
Table Games and Cage and Credit and Card Games AE Review Checklist PDF WORD

Electronic Dissemination Authorization PDF

Gaming Device/Cashless Wagering Requests
Test Requirements for Gaming Devices used on Cashless Wagering Systems
    Revised: 06-11-02
PDF
Gaming Device/Cashless Wagering System Approval Request PDF

Gaming Device Modification Requests
Gaming Device Software Modification Request Form
    Revised: 11/29/2007
PDF
Gaming Device Hardware Modification Request Form
    Revised: 11/29/2007
PDF
Gaming Device Feature Codes
    Revised: 11/29/2007
PDF

New Gaming Device Submissions
New Gaming Device Submission Package PDF

Software Problem/Malfunction Notification
Gaming Device Software Problem/Malfunction Notification PDF

System Based, System Supported, and Mobile Gaming Systems
User's Request for Installation of a System Based, System Supported, or Mobile Gaming System PDF
System Based, System Supported, and Mobile Gaming System Installation Request Submission Requirements
    Revised: 6/4/2009
PDF


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