Bingo Forms

Printing Instructions

Most of these forms are available in a "Fill-able" format, meaning you can view, complete, and print the form on your computer. These forms use the features provided with Adobe Acrobat. Currently, there is no validation or verification of the information you enter, and you are responsible for entering and checking all required information. Instructions may require some information to be handwritten on the form (signatures, for example).

Note: The Acrobat Reader does not allow you to save your completed forms. You should print two copies -- one to mail, and one to keep for your records.

Class I Bingo


Form Title	Type	Form #	Document
Checklist (Make Sure Your Application is Complete)	Applications		Form
Nebraska Application for Bingo, Lottery, or Lottery by Pickle Card	Applications	50	Form
Schedule I, Bingo License	Applications	50	Form
Nebraska Application for Utilization of Funds Member	Applications	50H	Form
Nebraska Bingo Tax Return	Reporting	51B	Form
Schedule I, Bingo Occasion Activity Report	Reporting	51B	Form
Nebraska Class I Bingo Annual Report - View and Print Only	Reporting	35	Form

Class II Bingo


Form Title	Type	Form #	Document
Checklist (Make Sure Your Application is Complete)	Applications		Form
Instructions for Completion of BIENNIAL License Renewal Application	Applications		Form
Nebraska Application for Bingo, Lottery, or Lottery by Pickle Card	Applications	50	Form
Schedule I, Bingo License	Applications	50	Form
Nebraska Application for Utilization of Funds Member	Applications	50H	Form
Nebraska Application for Gaming Manager	Applications	50C	Form
Instructions for Completing Fingerprint Application	Applications		Form
Background Check Waiver	Applications		Form
Nebraska Bingo Tax Return	Reporting	51B	Form
Schedule I, Bingo Occasion Activity Report	Reporting	51B	Form
Nebraska Class II Bingo Quarterly/Annual Report - View and Print Only	Reporting	35C	Form

Special Event Bingo


Form Title	Form #	Document
Nebraska Application for Special Event Bingo Permit	50J	Form

Commercial Lessor


Form Title	Form #	Document
Nebraska Application for Commercial Lessor of Bingo Premises	50B	Form
Schedule I, Registration of Bingo Premises	50B	Form

Manufacturer & Distributor


Form Title	Form #	Document
Nebraska Application for Manufacturers, Distributors, and Manufacturer-Distributors	50A	Form
Personal History Record and Background Disclosure Form for Charitable Gaming Licensees and Nebraska (State) Lottery Vendors		Form
A Summary of Your Rights Under the Fair Credit Reporting Act		Form
Affidavit by Spouse for Waiver of Fingerprinting and/or Personal History Record and Background Disclosure Form for Charitable Ga		Form
Instructions for Completing Fingerprint Application		Form
Background Check Waiver		Form
Nebraska Licensed Manufacturers		Document
Nebraska Licensed Distributors		Document

Miscellaneous


Form Title	Form #	Document
Request for Abatement of Penalty	21	Form
Power of Attorney	33	Form

Charitable Gaming