| INSTRUCTIONS |
|
|
| To electronically complete these forms please download and edit them with Adobe Acrobat. Once complete, save the file and return it to the GCB according to the instructions on the form. |
|
|
| APPLICATION AND INVESTIGATIVE FEE SCHEDULE |
PDF |
|
| NONRESTRICTED |
|
|
| 1. Nonrestricted Gaming License |
PDF |
|
| 2. Nonrestricted Gaming License as a Key Employee |
PDF |
|
| 3. Manufacturer and/or Distributor License |
PDF |
|
| 4. Manufacturer of Interactive Gaming Systems or Associated Equipment License |
PDF |
|
| 5. Preliminary Determination Location Suitability |
PDF |
|
| 6. Operator of Interactive Gaming License |
PDF |
|
| 7. Information Service License |
PDF |
|
| 8. Disseminator License |
PDF |
|
| 9. Conduct Racing License |
PDF |
|
| 10. Conduct Pari-Mutuel Wagering License |
PDF |
|
| 11. Approval to Participate in Pari-Mutuel Commission |
PDF |
|
| 12. Gaming Salon License |
PDF |
|
| 13. Approval to Grant an Option |
PDF |
|
| 14. Operate a Call Center |
PDF |
|
| RESTRICTED |
|
|
| 1. Restricted Gaming License |
PDF |
|
| 2. Restricted Space Lease Gaming License |
PDF |
|
| 3. Participation in Restricted Gaming Revenue |
PDF |
|
| 4. Restricted Gaming License as a Key Employee |
PDF |
|
| REGISTRATION |
|
|
| 1. Minority Equity Owner |
PDF |
|
2. Independent Testing Lab Registration
|
PDF |
|
3. Associated Equipment NEW Registration
|
PDF |
|
| 4. Associated Equipment RENEWAL Registration |
PDF |
|
5. Independent Host NEW Registration
|
PDF |
|
| 6. Independent Host RENEWAL Registration |
PDF |
|
| 7. Independent Agent NEW Registration |
PDF |
|
| 8. Independent Agent RENEWAL Registration |
PDF |
|
| 9. Service Provider NEW Registration |
PDF |
|
| 10. Service Provider RENEWAL Registration |
PDF |
|
| 11. Hosting Center NEW Registration |
PDF |
|
| 12. Hosting Center RENEWAL Registration |
PDF |
|
| 13. Registered Hosting Center Requesting Additional Facility and Services |
PDF |
|
| 14. Hosting Center Facility and Services Requirements |
PDF |
|
| Forms and Applications |
|
|
| Form 1 Application For a Nevada Gaming License (Individuals) |
PDF |
|
| Form 1A Application for a Preliminary Finding of Suitability |
PDF |
|
| Form 1R Application for Registration |
PDF |
|
| Form 1R ADDENDUM |
PDF |
|
| Form 2 Application For Approval by Corporation/Partnership/ LLC |
PDF |
|
| Form 3 Application For Registration by Holding Company/ Intermediary Company |
PDF |
|
| Form 4 Personal History Record |
PDF |
|
| Form 4R Personal History Record New (Registration Applications only) |
PDF |
|
| Form 4RR Personal History Record Renewal (Registration Applications only) |
PDF |
|
| Form 5R Personal Financial Questionnaire (Registration applications only) |
PDF |
|
| Form 6 Statement of Pre-opening Cash/First Years Cash Flow |
PDF |
EXCEL |
| Form 7 Multi Jurisdictional Personal History Disclosure Form |
PDF |
|
| Form 7A Nevada Supplemental Personal History Disclosure Form |
PDF |
|
| Form 9 Independent Agent Yearly Reporting Guidelines |
PDF |
|
| Independent Agent Yearly Report Template |
|
EXCEL |
| Form 10 Affidavit of Full Disclosure |
PDF |
|
| Form 15 Location/Landlord Information Sheet |
PDF |
|
| Diagram Example - Convenience Store |
PDF |
|
| Diagram Example – Bar/Tavern |
PDF |
|
| Form 17 Release and Indemnity of All Claims |
PDF |
|
| Form 18 Request to Release Information |
PDF |
|
| Form 18R Request to Release Information (Registration Applications Only) |
PDF |
|
| Form 19 Application for Enrollment as an Agent |
PDF |
|
| Form 20 Source and Application of Funds (Restricted Gaming License only) |
PDF |
|
| Form 21 Application to Transfer Interest |
PDF |
|
| Form 27 3.015(2) Additional Requirements for Restricted Applications |
PDF |
|
| Form 28 Electronic Fingerprint Receipt |
PDF |
|
| Electronic Fingerprint Instruction Memo |
PDF |
|
| Fingerprint Locations |
PDF |
|
| Form 28A Fingerprint Background Waiver |
PDF |
|
| IAGR Multi-Jurisdictional form |
|
|
| Race Book and/or Sports Pool |
|
|
| Application Instructions for a Race Book and/or Sports Pool (8/20) |
PDF |
|
| Race Book-Sports Pool Questionnaire |
PDF |
|
Online Book Wagering Submission Process - effective 10/1/19
|
|
|
| BWR XML specifications and mapping |
PDF |
|
| ENF 123 Template |
|
EXCEL |
| Access Book Wagering Forms |
|
|
| Book Wagering Online Submission Training |
PDF |
|
| Listed Patron Approval |
PDF |
|
| Model Reserve Agreements |
* |
|
| Agreement Example |
* |
|
| Bond Example |
* |
|
| Sample Compliance Report |
* |
|
| *Questions regarding the race book and/or sports pool reserve requirements should be directed to the Audit Division, Las Vegas office, at gcblvaud@gcb.nv.gov or (702) 486-2060. |
|
|
| Suspicious Wager Report Instructions |
PDF |
|
| Suspicious Wager Report Form |
PDF |
|
| Foreign Gaming |
|
|
Foreign Gaming Reporting Requirements Policy Statement
(07-18-23) |
PDF |
|
| FG-710-1 Notification Statement (07-18-23) |
|
WORD |
| FG-710-2 Quarterly Report (07-18-23) |
|
WORD |
| FG-710-3 Termination Notice (07-18-23) |
|
WORD |
| Publicly Traded Corporations |
|
|
| Reporting Requirements |
PDF |
|
| Official Forms Instructions - Forms for use by Publicly Traded Corporations (03/06) |
PDF |
|
| PTC-1 Application (03/06) |
PDF |
WORD |
| PTC-2 Application for Registration or for Amendment to Order of Registration (03/06) |
PDF |
WORD |
| Form 17 Release and Indemnity of All Claims |
PDF |
WORD |
| PTC-110 Application for Approval of a Public Offering (03/06) |
PDF |
WORD |
| PTC-115 Application for a Continuous or Delayed Public Offering ("shell") (09/06) |
PDF |
WORD |
| PTC-200 Application for Approval of and Acquisition of Control (03/06) |
PDF |
WORD |
| PTC-250 Application for Approval of a Plan of Recapitalization (03/06) |
PDF |
WORD |
| PTC-260 Application for Approval of Exceptional Repurchase of Securities (03/06) |
PDF |
WORD |
| PTC-310 Application for Approval of a Proxy Statement or Information Statement (03/06) |
PDF |
WORD |
| PTC-430 Application for Waiver of NGC Reg. 16.430 as an Institutional Investor (03/06) |
PDF |
WORD |