APPLICATION TO CONDUCT RACING BY CORPORATION/PARTNERSHIP/LIMITED LIABILITY COMPANY (To be typewritten or printed legibly) The undersigned hereby makes application to conduct racing: 1. Name of Applicant entity Address of racing establishment Trade name to be used 2. Proposed date of opening 3. Indicate whether applicant is a: Corporation Partnership Limited Liability Company Federal I.D. No. 4. 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 a true copy of the Partnership Yes No Agreement is attached: If no, state reasons (c) A complete list of all stockholders, partners, or members showing the number of shares/interest held of Yes No record by each is filed herewith: If no, state reasons (d) List below the following information with respect to all partners, members, directors, officers, shareholders, and key employees. 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 RESIDENCE ADDRESS TITLE (e) If applicable, the terms, position, rights, and privileges of the different classes of securities outstanding: SECURITY Form 8_Application to Conduct Racing_Corp/Part/LLC (Rev. 1/11) TERMS AND POSITION -1- RIGHTS AND PRIVILEGES American LegalNet, Inc. www.FormsWorkFlow.com (f) Options existing or to be created in respect of their securities or other interest: NAME ADDRESS TITLE OPTIONS (Shares) OR OTHER INTERESTS 5. A general description of the nature of the business. (Attached a separate sheet if necessary) 6. List below the following information with respect to any persons who will received, directly or indirectly, any compensation or rents based on a percentage or share of the proceeds of the gaming venture. Each of the persons named below may be required to complete and file a Personal History Record and fingerprint impressions in duplicate: FULL NAME RESIDENCE ADDRESS TITLE OR NATURE OF INTEREST 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: (1) At all times reflect the ownership of every class of security issued by the corporation, partnership, or limited liability company; and (2) 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. (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 income 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 within 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 Certificate 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. 7. 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. 8. NRS 466.100(2) requires any applicant to pay all or any part of the fees or costs of investigation of such applicant as may be determined by the Licensing Agency. -2- American LegalNet, Inc. www.FormsWorkFlow.com THE OBLIGATIONS HEREIN CONTAINED ARE NOT INTENDED TO BE COMPLETE. CITY, COUNTY AND NEVADA LAWS AND REGULATIONS MUST BE FOLLOWED AND ARE APPLICABLE AT ALL TIMES. STATE OF ss. COUNTY OF I, , being duly sworn, depose and say that the above statements are true and correct to the best of my knowledge and belief and that this statement is executed with the knowledge that misrepresentation or failure to reveal information requested may be deemed sufficient cause for the refusal to issue a gaming license by a municipality, or by a county or by the State of Nevada. Further, that I am aware that later discovery of an omission or misrepresentation made in the above statements may be grounds for the revocation of a gaming license. Further, that I am voluntarily submitting this application under oath with full knowledge that the Gaming Control Act (NRS 463.140(5)) provides that “Any person making false oath in any matter before either the board or commission is guilty of perjury.” I am voluntarily submitting this application under oath with full knowledge that I may be required to submit this application to appropriate municipal and county authorities charges by law with granting gaming licenses. APPLICANT Entity By Signature Title SUBSCRIBED AND SWORN TO BEFORE ME THIS DAY OF , Notary Public NOTICE THIS APPLICATION MAY NOT BE WITHDRAWN WITHOUT THE PERMISSION OF THE LICENSING AGENCY -3- American LegalNet, Inc. www.FormsWorkFlow.com ATTACHMENT TO APPLICATION TO CONDUCT RACING BY CORPORATION/PARTNERSHIP/LIMITED LIABILITY COMPANY 1. The terms on which its securities are to be, and during the preceding 3 years have been, offered to the public or otherwise: SECURITY 2. TERMS 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 3. AMOUNT INTEREST TERMS 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 services, in the form of salary, wages, fees, or by contract, pertaining to the applicant: NAME 4. DATE TITLE OWNERSHIP % OR OTHER INTEREST REMUNERATION Remuneration to others than members, directors, and officers exceeding $40,000 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 5. REMUNERATION PURPOSE TERMS Bonus and profit-sharing arrangements 6. TITLE Management and service contracts: NAME CONTRACT ATTACH ADDITIONAL SHEETS, IF NECESSARY -4- American LegalNet, Inc. www.FormsWorkFlow.com