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Showing 109 - 120 of 121 results

Form Name	Number	Licensee	Entity	License
Service Supplier Application Addendum Service Supplier Application Addendum Form number Form GC4-025f Form Summary Use this form, along with the Commercial Business Application or Add an Activity application, to apply for or add Service Supplier activity to your license For licensee type Current licensee, New applicant Entity type Organization License Type Commercial Cancel Download as PDF (189.55 KB)	GC4-025f	Current licensee, New applicant	Organization	Commercial
Service Supplier Representative Application Packet Service Supplier Representative Application Packet Form number Form GC4-022f-pkt Form Summary Use this form to apply/work for a licensed gambling establishment or vendor. This packet contains all forms needed for a complete application for a Service Supplier Representative. For licensee type New applicant Entity type Individual License Type Commercial Cancel Download as PDF (593.04 KB)	GC4-022f-pkt	New applicant	Individual	Commercial
Shuffler Submission Checklist Shuffler Submission Checklist Form number Form GC4-327 Form Summary use this form along with New or Upgraded Electronic or Mechanical Equipment / Software application. This checklist is a compilation of Washington laws and rules, best practices, and industry standards. For licensee type Current licensee, New applicant Entity type Organization License Type Commercial Cancel Download as PDF (175.5 KB)	GC4-327	Current licensee, New applicant	Organization	Commercial
Source of Funds Statement Source of Funds Statement Form number Form GC4-321 Form Summary Use this form if you are a commercial business, or owner, officer of a commercial business to disclose your costs and source of funds information. For licensee type Current licensee, New applicant Entity type Organization License Type Commercial Cancel Download as PDF (80.18 KB)	GC4-321	Current licensee, New applicant	Organization	Commercial
Stock Ownership Change Notification Application Stock Ownership Change Notification Application Form number Form GC4-011a Form Summary Use this form if you are a corporation with Stock ownership changes. For licensee type Current licensee Entity type Organization License Type Commercial Cancel Download as PDF (197.82 KB)	GC4-011a	Current licensee	Organization	Commercial
Stock Ownership Change Notification Application Packet Stock Ownership Change Notification Application Packet Form number Form GC4-011a-pkt Form Summary Use these forms if you are a corporation with Stock ownership changes. This packet contains all forms needed for a complete application. For licensee type Current licensee Entity type Organization License Type Commercial Cancel Download as PDF (851.75 KB)	GC4-011a-pkt	Current licensee	Organization	Commercial
Table Games Jackpot System Submission Checklist Table Games Jackpot System Submission Checklist Form number Form GC4-328 Form Summary use this form along with New or Upgraded Electronic or Mechanical Equipment / Software application. This checklist is a compilation of Washington laws and rules, best practices, and industry standards. For licensee type Current licensee, New applicant Entity type Organization License Type Commercial Cancel Fill out online (SAW)	GC4-328	Current licensee, New applicant	Organization	Commercial
TGA Incident report form, for Tribal Lottery System (TLS) equipment only TGA Incident report form, for Tribal Lottery System (TLS) equipment only Form number Form GC16-005 (Rev. 5/03) Form Summary Use this form to report TLS incidents to the WSGC Electronic Gambling Lab For licensee type Current licensee Entity type Organization License Type Commercial Cancel Download as PDF (27.8 KB)	GC16-005 (Rev. 5/03)	Current licensee	Organization	Commercial
Transfer Application Transfer Application Form number Form GC4-011b Form Summary Use this form to request to transfer your license (e.g. Change of Business Classification, transfer to due bankruptcy or death.) For licensee type Current licensee Entity type Organization License Type Commercial, Nonprofit Cancel Download as PDF (212.91 KB)	GC4-011b	Current licensee	Organization	Commercial, Nonprofit
Transfer Application Packet Transfer Application Packet Form number Form GC4-011b-pkt Form Summary Use these forms to request to transfer your license (e.g. Change of Business Classification, transfer to due bankruptcy or death.) This packet contains all forms needed for a complete application. For licensee type Current licensee Entity type Organization License Type Commercial Cancel Download as PDF (910.71 KB)	GC4-011b-pkt	Current licensee	Organization	Commercial
Tribal Authorized Signatures Form Tribal Authorized Signatures Form Form number Form GC4-331 Form Summary Use this form if you are a tribal employer with licensed employees to authorize certain staff to sign individual applications on behalf of the tribe. For licensee type Current licensee, New applicant Entity type Individual License Type Class III Cancel Download as PDF (16.2 KB)	GC4-331	Current licensee, New applicant	Individual	Class III
Tribal Only Equipment (non-TLS) Packet Tribal Only Equipment (non-TLS) Packet Form number Form GC4-332-pkt Form Summary Use these forms to request approval for a gambling equipment or software for the tribal market only. This packet contains all forms needed for a complete application. For licensee type Current licensee, New applicant Entity type Organization License Type Commercial Cancel Download as PDF (277.79 KB)	GC4-332-pkt	Current licensee, New applicant	Organization	Commercial

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