Eligibility to Conduct Bingo Games in the City of Fortuna Fortuna Municipal Code States the Following:
5.16.030 Eligibility to conduct bingo games.
No person, organization, or other legal entity shall be permitted to conduct bingo games in the city unless such persons, organizations, or other legal entities possess a valid certificate or letter from the Franchise Tax Board and the Internal Revenue Service stating that they are exempted from the payment of the bank and corporation tax by Section 23701(d) of the Revenue and Taxation Code and that a contribution or gil to them would be a charitable contribution under Section 170(c)(2) of the Internal Revenue Code of 1954 and possess a valid permit issued pursuant to the provisions of this chapter. (Ord. 77-373 § 3).
5.16.040 Permit - Required - Application.
A. No person or organization shall conduct a bingo game without obtaining a permit from the city council to do so.
B. Written application for a permit required by this chapter shall be made by affidavit under penalty of perjury and filed with the city clerk.
Please provide the following information to the City of Fortuna to process your Bingo Application:
Name of Organization: _ Kiwanis Club of Riodell-Scotia
Name(s), Signature(s) and Addresses(s) of Organization Officers):
1.) Printed Name of Officer: Shannon Brasher
Address of Officer: 0 BOx 821 Rio Dell, CA 955U2
shE, president
Signature of Officer:
2.) Printed Name of Officer: Dana A. Webb
Address of Officer: P.O. Box 82, Rio Dell, CA 95542
Signature of Officer: DanaQN, Treasurer
3.) Printed Name of Officer: _
Address of Officer:
Signature of Officer:
Days and Hours of Operation of Bingo Games: Friday, June 20th, 7-9p.m. *If Bingo is being hosted in a City of Fortuna Venue, please write the name of the venue.
The RiverLodge
Address of premises where bingo games will be conducted: 1800 Riverwalk Drive Statement of ownership or lease of premises: We do have an agrement to rent Purpose to thin such premises are used by the givethodge all day on ne 20,2025.
Christmas presents go for Bait et raise funds tor sesas and Scotia elementarykids.
Eligibility to Conduct Bingo Games in the City of Fortuna statement of owner beis ecupment used in the operation of bingo games: laptop to dran online Our bingo cardo ase paper - order onumber from Amazon and thram aways afterward
Statement of consent for chief of police to inspect any bank accounts containing profits derived from bingo games:
isspect any bank accont
corporation, pair orahiatrother legal entity which has a financial interest in the conduct of bingo games for your organization:
inanis Cub Femintans Rio Dell-Scotia (Also Rio Pell Elementany and Scatia Schools. They get gifts for the
Kido not a moners donation.
lame of person responsible for the operation of the bingo games Dana. A. Webb, Chairperson
Your organization must provide copies of certificates or letters evidencing exempt status under Section 23701(d) of the Revenue and Taxation Code and Section 170(c)(2) of the Internal Revenue Code of 1954, received from the Franchise Tax Board and the Internal Revenue Service. *The City a may request further information as may be required by the city council. (Ord. 77-373 §§ 18, 19).
In addition, you application will be presented for Council consideration at a publicly noticed Public Hearing. You will be contacted regarding the date of your hearing. Permits are non-transferable and may be revoked or suspended
For additional information or any questions regarding this form, please contact the City Clerk at 707-725- 7600 or you can email directly to [email protected].