Regulation 6.130 Count Personnel List For Group I Licensees
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Regulation 6.130 Count Personnel List For Group I Licensees Form. This is a Nevada form and can be use in Nevada Gaming Commission And State Gaming Contol Board Statewide.
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NEVADA GAMING CONTROL BOARD
REGULATION 6.130 COUNT PERSONNEL LIST
FOR GROUP I LICENSEES
Page ____ of ____
Licensee:_______________________________________________ Location No.: ________________
Quarter Ending: __________________ (Mo./Day/Yr.)
Participates in:
Employee Name
Job Position
SS#
Tabl Slots
e
(Soft)
(Soft)
Slots
(Coin)
Allowed
in Count
Room Only
(1)
Ownership
Interest
(2)
Relationship
(3)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
1. For those individuals who are not count team members, but are allowed access to the count room during the count, indicate with “TS” (table soft),
“SS” (slots soft) or “SC” (slots coin).
2. Disclose if count team member has any ownership interest in licensed operation.
3. Disclose any relationship (by blood or marriage) a count team member has with other count team members, any interest holder or employee of
the gaming establishment. (Indicate name and relationship in space provided or in attachment.)
Submitted by _________________________________
Phone Number ___________________________
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