Bunker Hill Gambling License
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MEMORANDUM
April 10, 2006
TO:
The Honorable Mayor and City Council Members
FROM:
Michael C. Van Milligen, City Manager
SUBJECT: Approval of Gambling License
Leisure Services Manager GiI Spence recommends City Council approval of a gambling
license to conduct two raffles at the Bunker Hill Golf Course for items donated by Harris
Motor Sports.
I concur with the recommendation and respectfully request Mayor and City Council
approval.
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MiChael C. Van Milligen
MCVM/jh
Attachment
cc: Barry Lindahl, Corporation Counsel
Cindy Steinhauser, Assistant City Manager
Gil D. Spence, Leisure Services Manager
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MEMORANDUM
April 10, 2006
TO: Michael C. Van Milligen, City Manager
FROM' GU D. Speo"", le;,"~ SeMoos M'",9~
SUBJECT: Approval of Gambling License
INTRODUCTION
The purpose of this memorandum is to request City Council approval of a gambling
license to conduct two raffles at the Bunker Hill Golf Course.
DISCUSSION
Part of the golf car agreement with Harris Motor Sports was that they donate four one-
day passes to the Western Open and a playing spot in the Pro-Am of the Western Open
to be raffled to raise money for the golf course. We plan to have separate raffles for the
two prizes.
To conduct the raffles we need to obtain a gambling license from the state. City
Attorney Barry Lindahl has reviewed the application and advised that the city manager,
assistant city manager, and I should be listed as the officers; social security numbers
will be added prior to the application being sent to the state.
Raffle tickets will be sold at the pro shop for $5.00 each or three for $10.00. Our goal is
to generate at least $1,000 of revenue for the golf course.
ACTION STEP
The action requested is that the City Council approve the attached gambling license
application.
GDS:et
tor office use only
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IOWA DEPARTMENT OF INSPECTIONS AND APPEALS
GAMBLING LICENSE APPLICATION
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LICENSEE INFORMATION
Name of Licensee (organization. business or person):
FederallD Number
Sales Tax Number
C!TY OF DUBUQUE
Name of Group, Charter or Business. If Different From Above:
42-6004596
1--3.1015667
Business Telephone Number of the Responsible Party (Include area code):
BUNKER HILL GOLF COURSE
( 563) 589-4261
Responsible Party (first name, middle initial, last name)
Social Security Number
GIL D. SPENCE
Responsible Party's Mailing Address
City
County
State
Zip Code'
2200 BUNKER HILL ROAD
DUBU UE
DUBU UE
IA
2 1
:It New License (No previous license)
1j License Renewal
Previous Gambling License Number:
Date you want this license to begin:
MAY 1, 2006
BINGO LOCATION INFORMATION A landlord or relatives of the landlord cannot be involved in the operation of bingo or concession sales at a
bingo occasion. If the landlord or any relative of the landlord has any involvement in the operation of bingo or the concessions, attach a written
explanation.
Street Address
City:
State'
Zip Code
For Bingo:
Name of Landlord (if applicable):
Landlord's Telephone Number (include area code):
DOwned
D Rented
Landlord's Mailing Address:
City
State
Zip Code
SOCIAL LICENSE INFORMATION
Location Name:
Location Address:
City:
State:
Zip Code:
Location Phone:
( )
RAFFLE LICENSE I%O~ATlON
t8I: Citywide 'tI 'II tfIP2.
(city) 0 Countywide
(county) 0 Statewide
All ADDlicants
Although gambling license application processing time is typically one to two weeks, Iowa law allows the Department up to 30 days to review and
investigate a gambling license applicant. Please keep this in mind when applying for a license and planning your event.
The Department may require additional information if deemed necessary to render a decision on this application. If you do not provide the required proof
along with your complete gambling license application, your application cannot be processed and will be returned.
All applicant organizations or businesses must be licensed, registered, and located in Iowa. A written credit reference must be attached to the
application. The credit reference must be from a banking institution or other entity with whom the applicant does business and should state that the
applicant has an account with them and whether or not the account is in good standing.
Law enforcement must sign the application form on page four. The law enforcement signature affirms notification to the agency that they are aware
that gambling will be occurring in their jurisdiction.
The Responsible Party listed must be a person (not an organization). The person listed must be an officer, board member or other person who has
the authority to sign for the applicant. The Responsible Party's social security number must also be listed on page one of the application. The
Responsible Party's Mailing Address on page one of the application is the address where the license and future quarterly report forms will be mailed.
,
Political Parties or Affiliates
A political party or political party organization is a qualified organization for purposes of obtaining a type 06, 07, 08, 09, 10, or 13 gambling license.
Political party or political party organization means a political party as defined in Iowa Code section 43.2, a county statutory committee, a nonparty
political organization that has qualified to place a candidate as its nominee for statewide office pursuant to Iowa Code section 44.1, or a candidate
committee as defined in Iowa Code section 56.2. The Iowa Ethics and Campaign Disclosure Board shall verify an applicant's status before a license is
approved. Political Action Committees (PACs) are not permitted to obtain a gambling license under Iowa Code Chapter 99B.
Tvee 07. 08. 09.10, or 13 license ADDlicants
If you are applying for a type 07, 08, 09, 10, or 13 gambling license, you must provide proof of your organization's tax.exempt status. Under Iowa
Code and Administrative Rules, proof must be in the form of a determination letter from the Internal Revenue Service (IRS) stating that your organization
is exempt from federal income tax under Internal Revenue Code section 501 (c)(3), (4), (5), (6), (7), (8), (10) or (19).
Each organization holding a type 06. 07, 08. 09, 10, or 13 gambling license must complete and file a quarterly gambling report showing the licensee's
gross gambling income, disbursements, and total income. AJllicensees must pay state sales tax on their gross gambling proceeds. In general. the only
exceptions to payment of sales tax exist for city or county governments and certain agricultural associations. If you have questions about payment of
sales tax, you should contact the Department of Revenue and Finance at 1-800-367-3388.
Check the tvpe of License vou are requesting:
o 01 Amusement Concession License (One year)
Authorizes concession games of skill/chance at a fair, amusement park, or local celebration. Applicants for
an Amusement Concession License (type 01) do not need to obtain a law enforcement official's signature
and do not need to provide a credit reference.
D 02 Amusement Sponsor's License (14-day)
Authorizes the sponsor of a carnival, bazaar, or celebration to conduct games of skill/chance with written
permission from a city councilor county board of supervisors. (No raffles)
D 03 Social Gambling - Beer & liquor Establishments (Two year)
Authorizes small stakes card and parlor games between individuals. Sports-betting pools may be conducted.
D 04 Social Gambling - Public Places (Two year)
Authorizes small stakes card and parlor games between individuals.
D 05 Raffle At Fair (Duration of Fair)
Each license authorizes one raffle conducted by either the sponsor of the fair or a licensed qualified
organization with written permission from the fair board.
D 06 Annual Game Night (12-hour Casino)
Authorizes small games of skill or chance and limited casino-type games. Issued once per calendar year for
12 hours. If you are conducting the game night for purposes of fund raising, your organization must be a
qualified organization and hold a type 07, 08, 09, 10, or 13 qualified organization license during the same
time the type 06 game night license is being held. If you are conducting the game night for purposes of
entertainment and no fundraising is involved, you only need to hold the type 06 license. You cannot charge
admission to play the games. You cannot play with real money. The participants must have something in
common other than gambling; for example, they all work for the same employer.
D 07 Qualified Organization (Two year)
Authorizes small games of skill or chance, bingo and raffles by tax-exempt organizations. No casino-type
games. Applicants must have been active for the past five consecutive years. Applicants must either have a
sales tax permit or have made application for a sales tax permit. If bingo will be conducted, provide the name
of the person who will be responsible for the management of the games in the space provided:
D
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Qualified Organization (14-day)
Authorizes small games of skill or chance, bingo and raffles by tax-exempt organizations. No casino-type
games. The sale of tickets and the drawing of a raffle must both occur within the 14-day period.
Qualified Organization Raffle (90-day)
Authorizes raffles for fund-raising by tax-exempt organizations. The sale of tickets and the drawing of a raffle
must both occur within the 90-day period.
Qualified Organization Raffle (180-day)
Authorizes raffles for fund-raising by tax-exempt organizations. The sale of tickets and the drawing of a raffle
must both occur within the 180-day period.
Qualified Organization Annual Raffle License (One Year)
Authorizes raffles for fund-raising by tax-exempt organizations. The sale of tickets and the drawing of a raffle
must both occur within the one-year period.
Qualified Organization Real Properly or Cash Prizes $100,000 to $200,000
Authorizes raffles for fund-raising by tax exempt organizations, which hold a #07 or #13 raffle license, to have
one (1) large raffle per year involving real property or a cash prize of $1 00,000 but not more than $200,000.
Real property must be acquired by gift or have been owned by the organization for at least five (5) years. An
Annual Real Property Raffle License Application is required for this license type. Further requirements are
addressed on the additional aoolication. Calf (515) 281-6848 to request the application form.
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D
13
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License Fee
$50 per game
$25
$150
$100
$30 per raffle
$25
$150
$15
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$75
$150
$100
Mark the approDriate response to each statement reaardina your aDDlication:
l'i1r Yes D No Is there a beer or liquor license at this location?
If you are applying for a two-year license, does another qualified organization already have a two-year
DYes D No license at this location? If "yes," what is the name of the organization:
DYes D No If you are applying for a two-year license, will another two~year licensee conduct bingo at this location?
DYes D No Is rent based on a percentage of the total gambling receipts?
DYes ---r;rNo Do you have to pay a penalty or fee if the rental agreement is terminated?
(;l(No Has a gambling license been revoked at this location? If "yes:' what is the name and license number of the
DYes revoked organization:
DYes DNo If you are applying for a two-year license, has this organization been active for less than five years?
()(I'Yes DNo Are the responsible party and all officers/board members United States Citizens?
DYes ~No Have any of them been convicted of a felony, pled guilty, or been convicted of a serious or aggravated
misdemeanor within the nast two vears?
DYes l'Jo Does the organization have any state tax liabilities?
DYes No Has this organization had a gambling license revoked?
DYes No Has an Iowa liquor or beer permit been suspended or revoked with this organization?
DYes No Has the organization held an annual game (casino) night license during this calendar year?
Describe the anticipated gambling activity. (If the activity includes a raffle, please detail the anticipated cost per ticket, value of
prizes distributed, duration of ticket sales, and date of prize drawing.)
There will be 2 separate raffles, one for four single day sky box tickets to the
Western Open golf tournament and one for a playing spot in the Pro-Am of the Western
Open. Total value of the two prizes is $2,200. The drawing will be held on
June 12, 2006; tickets would be $5.00 each or 3 for $10.00.
ORGANIZATION/BUSINESS INFORMATION
What is the total number of active members in your organization? 0
(Must have 12 or more active members)
List officers and board members. (Attach additional sheets if necessary.)
Name: Social Security Number: Telephone Number (inClude area code)'
MICHAEL C. VAN MILLIGEN (564 589-4110
Street Address' City State: Zip Code'
50 WEST 13TH STREET DUBUQUE IA 52001
Name: Social Security Number Telephone Number (include area code):
CINDY STEINHAUSER (56J 589-4110
Street Address: City State Zip Code:
50 WEST 13TH STREET DUBUQUE IA 52001
Name Social Security Number' Telephone Number (include area code):
GIL D. SPENCE (56J 589-4263
Street Address: City: State Zip Code'
2200 BUNKER HILL ROAD DUBUQUE IA 52001
QUESTIONS
. If you have gambling license questions, please call the Department of Inspections and Appeals at (515) 281-6848, or visit the Department's
web site at www.state.ia.us/Qovernmentfdia.
If you have sales tax questions, please call the Department of Revenue and Finance at 1-800~367-3388.
If you have questions about your organization's income tax exempt status, please call the Internal Revenue Service (IRS)
at 1-800-829-1040.
If you need a form 1023 or 1024 - application for tax exempt status, please call the Internal Revenue Service (IRS)
at 1-800-829-3676, or you can download the forms from the IRS web site at hno:llwww.irs.ustreaS.aov.
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Attention Law Enforcement Officials
Your signature indicates you are aware of this gambling IicenE! application and that gambling may occur in your jurisdiction.
Signature of Chief of Police/County Sheriff
Department
Date
Attention Applicant
I acknowledge that:
I am subject to investigation or audit by the Department of Inspections and Appeals, the Department of Public Safety, the
Attorney General, or local law enforcement officials;
I am aware that a gambling event or occasion must not CECur before a license or an authotzation number has been issued.
Under Penalty of Perjury, I certify that I have examined this application art! accompanying documents, and to the best of my
knowledge and belief, the statements are true, correct and complete. I am aware that a person who, while under oath or affirrrtiDn in
any proceeding or other matter in which statements under oath or affirrretion are required or authorized by law, knowingly makesa
false statement of material facts or who falsely deniesknowledge of material facts, commits a class "D" felony.
Signature of Applicant
Title
Date
Make check payable to:
Treasurer - State of Iowa
Mail application to:
Iowa Department of Inspections and Appeals
Social and Charitable Gambling Program
Lucas State Office Building
321 East12'h Street
Des Moines, Iowa 50319-0083
427-2516 (revised 09/04)
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