Form 2 Application by Corp Partnership LLC (Rev 04/18) Page 1 of 6 APPLICATION FOR A NEVADA GAMING LICENSE APPROVAL BY CORPORATION/PARTNERSHIP/LIMITED LIABILITY COMPANY The undersigned hereby makes application for a gaming license/approval: 1. Name of applicant entity T rade name to be used Federal I.D. No. If application is to replace a license obtained under another name at the same location, state former name: Physical A ddress Street Address Suite/Unit City State ZIP Code Mailing Address Street Address Suite/Unit City State ZIP Code Contact Person Last First M.I. Email Address REQUIRED Telephone Number 2. Proposed date of opening 3. Complete the following (if the applicant is a partnership, limited liability company, or other form of business organization, furnish similar information as that requested below): a. State of incorporation/organization Date Date of qualification to do business in the State of Nevada b. A certified copy of the Articles of Incorporation, Articles of Organization, or true copy of the Partnership Agreement is attached: Yes No If no, state reasons c. A complete list of all stockholders, partners, or members showing the number of shares/interest held of record by each is filed herewith: Yes No If no, state reasons d. List below the following information with respect to all partners, members, directors, officers, and shareholders. Each of the persons named below may be required to complete and file a Personal History Record/Disclosure and other related application documents. Full Name Title/Position Percentage of Ownership American LegalNet, Inc. www.FormsWorkFlow.com Form 2 Application by Corp Partnership LLC (Rev 04/18) Page 2 of 6 e. If applicable, the terms, positions, rights, and privileges of the different classes of securities outstanding: Security Terms and Position Rights and Privileges f. Options existing or to be created in respect of their securities or other interest: Name Address Title Options (Shares) or Other Interests g. The terms on which its securities are to be, and during the preceding 3 years have been, offered to the public or otherwise: Security Terms Date h. The terms and conditions of all outstanding loans, mortgages, trust deeds, pledges, or any other indebtedness or security device pertaining to the gaming applicant: Security Device Amount Interest Terms i. The extent of the security holding or other interest in the applicant of all officers, employees, directors, underwriters, partners, members, principals, trustees, or any direct or beneficial owner, whether corporate or otherwise, and any remuneration as compensation for their serv ices, in the form of salary, wages, fees, or by contract, pertaining to the applicant: Name Title Ownership % or Other Interest Remuneration j. Remuneration to others than members, directors, and officers exceeding $50,000 per annum, and those who will receive, directly or indirectly, any compensation or rents based on a percentage of share of the proceeds of gaming by the applicant: Name Title Remuneration American LegalNet, Inc. www.FormsWorkFlow.com Form 2 Application by Corp Partnership LLC (Rev 04/18) Page 3 of 6 k. Bonus and profit - sharing arrangements l. Management and service contracts: Name Contract Purpose Terms ATTACH ADDITIONAL SHEETS, IF NECESSARY m. A general description of the business. ( Attach a separate page if necessary. ) 5. Type of License /Approval : Nonrestricted (over 15 devices and/or live gaming) Restricted (1 - 15 devices only) Restricted Space Lease Distributor Manufacturer Slot Route Operator Conduct Racing Disseminator Finding of Suitability Lender ( Si gnature of a present licensee is required ) Landlord ( Si gnature of a present licensee is required ) Participation in Gaming Revenue ( Signature of a present licensee is required ) Other Signature of Licensee Print Name Title Gaming Salon Information Services American LegalNet, Inc. www.FormsWorkFlow.com Form 2 Application by Corp Partnership LLC (Rev 04/18) Page 4 of 6 Interactive Gaming Manufacturer of Interactive Gaming Systems Distributor of Interactive Gaming Systems Manufacturer of Equipment Associated with Interactive Gaming Systems Interactive Gaming Service Provider (Class 1) Operator of Interactive Gaming Key Employee (for corporations) Operator of a Call Center Pari - Mutuel Wagering New license at location? (Proposed date of opening ) Racing Events Sporting Events Pari - Mutuel Systems Operator Shareholder Total percent % Number of shares/units Purchased From: Treasury Individual Service Provider (Class 2) Cash Access and Wagering Instrument Service Provider Geo - Location Service Provider Information Technology Service Provider Patron Identification Service Provider Payment Processing Service Provider Other 6. List below all games, tables, and gaming devices for which a gaming license is being sought: GAMES NO. TABLES NO. GAMING DEVICES NO. Craps Panguingui 5242 Roulette Poker 10242 Twenty - one Other (describe): 25242 Keno 50242 Bingo $1 Wheel of Fortune $5 Baccarat $25 Pai Gow $100 Race Book Multi - denominational Pari - Mutue l? (Yes/No) Other (describe): Sports Pool Pari - Mutuel? (Yes/No) Other (describe): TOTAL TOTAL TOTAL 7. The applicant agrees, if required: a. To maintain an office on the licensed gaming premises. b. To maintain a ledger in the principal office of the business in Nevada, which shall: i. At all times reflect the ownership of every class of security issued by the corporation, partnership, or limited liability company; and ii. Be available for inspection by the Licensing Agency and their authorized agents at all reasonable times without notice. c. To provide any further financial data or other information which may be deemed necessary or appropriate. American LegalNet, Inc. www.FormsWorkFlow.com Form 2 Application by Corp Partnership LLC (Rev 04/18) Page 5 of 6 d. To submit herewith balance sheets and profit and loss statements, certified by independent certified public accounts, certified or registered in the State of Nevada, for not more than the 3 preceding fiscal years, or, if the entity has not been in existence more than 3 years, such balance sheets and profit and loss statements from the time of its establishment. e. To provide to the Licensing Agency an annual profit and loss statement and balance sheet, and a copy of its annual federal inco me tax return within 30 days after such return is filed with the Federal Government. f. To provide to the Licensing Agency, at least annually, a complete list of all stockholders, partners, or members after this registration is approved, and in all cases wit hin 30 days after the annual meeting of stockholders of the corporation showing the number of shares held by each. g. That every security issued by it shall bear a statement, on both sides of the certificate, as is required by NRS 463 and the Regulations of the Nevada Gaming Control Board and Nevada Gaming Commission. h. To report to the Licensing Agency any change in corporation personnel who have been designated by the Licensing Agency as key executives. i. To terminate the employment of any person employed by it found unsuitable to hold a gaming license in the State of Nevada. j. To disallow the sale, assignment or transfer, pledge, or other disposition of any new issue of security, unless registered in advance with the Licensing Agency. A duly executed Certific ate of Resolution of the Board of Directors of the corporation to this effect shall be filed herewith. k. To assist the Licensing Agency in requiring the individual owner of any security who has been found unsuitable to continue as a gaming licensee in this State, to offer the stock for sale to the issuing entity, and that such entity will purchase the stock if it is able to do so; and in the vent the stock is retained by the unsuitable owner, the entity will not pay any dividend or interest on such security, allow it to be voted, or pay to the owner any remuneration in any form. l. Officers and other key employees of the applicant when requested shall execute an application and file same with the Licensing Agency in accordance with their request. m. NRS 463.150(f ) requires a