Regulation 14.180 Application - Licensed Manufacturers And Distributors Forms
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Regulation 14.180 Application - Licensed Manufacturers And Distributors Forms Form. This is a Nevada form and can be use in Nevada Gaming Commission And State Gaming Contol Board Statewide.
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Tags: Regulation 14.180 Application - Licensed Manufacturers And Distributors Forms, Nevada Statewide, Nevada Gaming Commission And State Gaming Contol Board
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14.180 APPLICATION
Addendum
MANUFACTURER
YEAR
DESCRIPTION
SERIAL #
MODEL #
SELLER ID
DENOM.
CT
PRICE
TT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
(CT=Currency Type(F-T-U-M-O),TT=Transaction Type (S-L-V))
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PURCHASER'S STATEMENT
I, ______________________________, declare under penalty of perjury
that each gaming device, as identified more fully on the attached
Regulation 14.180 Application, will be used only for lawful purposes,
specifically _________________________________________________
___________________________________________________________
__________________________________________________________.
(describe intended use)
I acknowledge that all subsequent distribution of these devices must
conform to all local, state, federal and foreign laws.
_____________________________________________
Print Name
_______________________________________ _________________
Signature of Purchaser
Date
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