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Gambling and Liquor Forms and Other Documents
The following documents are available to download, fill in, save and print. You may fill the form in on your computer, save and print the completed form or you may print and fill out the form manually. To save the typed in text in the PDF form, you must have Adobe Reader 7.03 or later. Please follow any instructions carefully. See Help for assistance with Portable Document Format (PDF) files.
Forms cannot be submitted online—they must be printed and delivered or mailed to:
Gambling Control Division
Department of Justice
2550 Prospect Avenue
P.O. Box 201424
Helena, MT 59620-1424
Department of Justice
2550 Prospect Avenue
P.O. Box 201424
Helena, MT 59620-1424
Helpful Hints
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Liquor licensing forms that are jointly available from the Montana departments of Revenue and Justice are noted with a "DOR/LQ" designation in the Form Number column.
| Title | Description | Form Number | Revised Date | Downloadable Format |
|---|---|---|---|---|
| Alcoholic Beverage/ Gambling Operator Combined License Application | Required for a new alcoholic beverage license and/or a new or amended gambling license. | 5 | 4/08 | PDF (Not a fillable PDF yet) |
| Antique Slot Machine Dealer License Application | A person may not sell more than three antique slot machines in a 12-month period without first obtaining this license. | 15 | ||
| Business Statement | Any change in management employees, officers or directors must be reported to the department. | 30 | 10/05 | |
| Card Room Contractor License Application | For a person who leases space from a licensed gambling operator to conduct legal card games. | 9 | 12/05 | |
| Certified Survey Affidavit | Required for a new alcoholic beverage license or a change of location. It establishes the quota area for a license. | Survey DOR/LQ |
10/07 | |
| Fire Code Letter | An informational letter alerting applicants to common fire code deficiencies in buildings. | 526 DOR/LQ |
4/07 | |
| Manufacturer/ Distributor/ Route Operator License Application | For licensing individuals who assemble, sell or lease gambling devices. | 17 | 12/05 | |
| Noninstitutional Loan or Other Noninstitutional Source of Financing and Noninstitutional Lender Authorization for Examination and Release of Information | To notify the department of any licensee intending to acquire a noninstitutional loan. The disclosure form allows the department to review necessary documents to determine qualification and suitability as a lender. | 13 | 3/08 | |
| On-Premise Notice | Acknowledges that an applicant for a new on-premise beer license within an incorporated city is not allowed gambling. | On-premnot DOR/LQ |
2/02 | |
| Personal/Criminal History Statement | All licensees, applicants, managers, officers or directors must complete this form. | 10 | 10/07 | |
| Secured Party Addition/ Assignment Form | To add a secured party to the face of an alcoholic beverage license or assign a security interest. | M-1 DOR/LQ |
1/05 | |
| Secured Party Continuation/ Termination Form | To remove a secured party from the face of an alcoholic beverage license or continue a secured party when a license transfers ownership. | M-2 DOR/LQ |
1/05 | |
| Special Tax Registration and Return Alcohol and Tobacco | A federal form provided as a courtesy. All retail alcoholic beverage licensees are required to get a special tax permit from the federal government. | ATF F 5630.5 DOR/LQ |
9/02 | |
| Sports Tab Game Seller License Application | For a person who intends to sell sports tabs to a sponsor. | 20 | 12/05 |
| Title | Description | Form Number | Revised Date | Downloadable Format |
|---|---|---|---|---|
| Live Card Table Application | A person who has been granted an operator's license may receive a permit for placement of a table. | 29 | 4/97 | |
| Live Keno/ Bingo Application | A person who has been granted an operator's license may receive a permit for live keno, live bingo or both. | 25 | 10/05 | |
| Video Gambling Machine Application | A person who has been granted an operator's license and a license to sell alcoholic beverages for consumption on the premises may obtain a video gambling machine permit. Permits are renewed each year and are prorated each quarter. | 8 | 10/06 | |
| Video Gambling Machine Letter of Withdrawal | To be submitted to the department when a permitted machine is removed from play prior to the annual June 30 renewal deadline. | 27 | 11/03 | |
| Video Gambling Machine Replacement Permit Request | To be submitted to the department when a permit is lost in the mail, after receipt, placed on the wrong machine, or for some other reason must be replaced. | 28 | 4/97 |
| Title | Description | Form Number | Revised Date | Downloadable Format |
|---|---|---|---|---|
| Calcutta Pool Application | For an organization wherein participants in the auction pool bid on the competitors in an underlying event. | 26 | 3/07 | |
| Card Dealer License Application | Required for individuals who wish to deal cards in live card games of panguingue or poker. The application package is not available online. See Card Dealer Licenses for further information. | Application package available from a driver exam station. | ||
| Card Game Tournament Permit Application | For an operator with an existing live table permit to apply for a permit to conduct card game tournaments. | 14 | 10/07 | |
| Casino Night Permit Application | For a nonprofit organization that wants to offer live card games, live bingo and raffles. | 11 | 3/07 | |
| Casino Night Reporting Form | For a nonprofit organization to report to the department a financial accounting of a casino night. | 12 | 3/07 |
| Title | Description | Form Number | Revised Date | Downloadable Format |
|---|---|---|---|---|
| Application to Import/ Export Gambling Devices or Associated Equipment | To apply for department approval to import or export illegal/legal gambling devices or associated equipment. | 22 | 11/03/97 | Page 1: PDF Page 2: PDF |
| VGMID Number Application Form | Used by video gambling machine (VGM) manufacturers to obtain VGMID numbers for new video gambling machines being introduced to the Montana market. | 35 | 7/07 | |
| Video Gambling Device Acquisition Notification | For reporting the purchase of a legal video gambling device from another licensee. | 19B | 11/01 | Page 1: PDF Page 2: PDF |
| Video Gambling Device Shipment Notification | For reporting the sale of a legal video gambling device to another licensee. | 19A | 12/01 | Page 1: PDF Page 2: PDF |
| Video Gambling Machine Service Form | For reporting the repair of a video gambling device when the repair may cause a loss of memory or change in the machine's meter readings. | 24 | 11/01 | Page 1: PDF Page 2: PDF |
| Title | Description | Revised Date | Downloadable Format |
|---|---|---|---|
| Manufacturers' Access List | Manufacturers must complete and submit this form when they initially submit a new VGM for testing and approval, and must update this document as changes occur. Division personnel discuss the manufacturer's products only with the authorized personnel listed. Each Access List submitted must be notarized. | 10/06 | |
| Modification Document | Manufacturers must complete and submit this document with each VGM modification submitted for testing and approval. Upon successful testing, the division returns the signed document to the manufacturer to certify approval. | 10/06 | |
| Montana SAS Serial Protocol Implementation Guide | New VGMs submitted for testing and approval must support the required minimum implementation of the Gaming Standards Association's (GSA) Slot Accounting System (SAS) protocol as defined in this Guide, per ARM 23.16.1920. | 7/24/03 | |
| New Gambling Device and Modification Submissions | Manufacturers must complete and submit this checklist when they submit a new video gambling machine (VGM) for approval. | 11/03/06 |
| Title | Description | Form Number | Revised Date | Downloadable Format |
|---|---|---|---|---|
| Live Keno/ Bingo Game Tax Return | Each location owner must complete this form for reporting and filing annual live game tax returns. | 16 | ||
| Machine Gross Income Page | Each machine owner or a designated representative must complete this form for reporting and filing quarterly tax reports and machine income. | 6(a) | 10/05 | |
| Quarterly Tax Reporting Form Instructions | Instruction form for machine owners to assist them in filling out quarterly tax returns. | QTRLY-INSTRUCT-SHEET | 12/05 | |
| VGM Quarterly Tax Reporting Form Cover Sheet | Machine owners must complete the cover sheet for location of machines, shares of machine income, tax payment due, and an authorized signature. | 6 | 9/04 | |
| VGM Reporting System Owner/Operator Registration | For location operators/machine owners to register the approved accounting and reporting system (including web entry) they will use to report video gambling machine tax data. | 34 | 10/07 | |
| VGM Reporting System Route Operator Registration | For route operators/machine owners to register the approved accounting and reporting system (including web entry) they will use to report video gambling machine tax data. | 34a | 10/07 |