Forms (Gambling & Liquor)

These forms are available to download, fill in, save and print. You may fill the form in on your computer 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. 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

Scroll down this page until you find the form you need. (New applicants should use the Alcohol Beverage/Gambling Operator Combined License Application in the Licensing section.)

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.

Licensing

Title Description Form Number Revised Date Downloadable Format
Alcoholic Beverage/ Gambling Operator Combined License Application and Liquor Authorization Form. Required for a new alcoholic beverage license and/or a new or amended gambling license. Liquor authorization forms required by the Department of Revenue. 5, Guide & LIQ-AUTH 6/13 and 3/13 Apply Online
Application
Guide
LIQ-AUTH
Antique Illegal Gambling Device Dealer License A person may not sell more than three antique slot machines in a 12-month period without first obtaining this license. 15 4/09 PDF
Business Statement Any change in management employees, officers or directors must be reported to the department. 30 11/12 PDF
Card Room Contractor License Application For a person who leases space from a licensed gambling operator to conduct legal card games. 9 3/09 PDF
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 PDF
Combined Amended Liquor and Gambling License Short Form Use this form to apply for a change in ownership among licensees resulting from a death, divorce, gift, or sale of ownership interest. This form can also be used for a change in location (Gambling Manf./Dist./Route Operator only) and changes related to foreclosure. 37 12/12 Apply Online
PDF
Fire Code Letter An informational letter alerting applicants to common fire code deficiencies in buildings. 526 DOR/LQ 4/07 PDF
Liquor and/or Gambling Short Form Use is limited to changes in type of business entity, increase of current ownership interest from less than 10% to more than 10%, and transer of location (GOA and/or ONP only). 39 1/13 Apply Online
App and Business Statement
Manufacturer/ Distributor/ Route Operator License Application For licensing individuals who assemble, sell or lease gambling devices. 17 10/09 PDF
NIL To notify the department of any licensee intending to acquire a non-institutional loan or other non-institutional source of financing. The disclosure form allows the department to review necessary documents to determine qualification and suitability as a lender. 13 3/08 PDF
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 PDF
Personal/Criminal History Statement All licensees, applicants, managers, officers or directors must complete this form. 10 10/07 PDF
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 PDF
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 PDF
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 PDF
Sports Tab Game Seller License Application For a person who intends to sell sports tabs to a sponsor. 20 5/09 PDF

Permit and Machine Licensure

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 PDF
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 PDF
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 PDF
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 PDF
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 PDF

Special Licenses

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 PDF
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. Renew online Application package available from a driver exam station.
Casino Night Permit Application For a nonprofit organization that wants to offer live card games, live bingo and raffles. 11 3/07 PDF
Casino Night Reporting Form For a nonprofit organization to report to the department a financial accounting of a casino night. 12 3/07 PDF
Large Stakes Card Game Tournament Permit Application & Notification From

For an operator with an existing live table permit to apply for an annual permit to conduct large stakes card game tournaments.

14A 9/24  PDF
Small Stakes Card Game Tournament Permit Application Form  For an operator with an existing live table permit to apply for an annual permit to conduct small stakes card game tournaments. 14B

9/24

PDF
Special Bingo Session Form
For an operator with an existing live bingo permit to apply for a permit to conduct a special bingo session. 38 8/11 PDF

Video Gambling Machine Shipment, Acquisition, Import, Export and Service

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 11/97 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 PDF
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

Tax Reporting

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 PDF
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 PDF
Quarterly Tax Reporting Form Instructions Instruction form for machine owners to assist them in filling out quarterly tax returns. QTRLY-INSTRUCT-SHEET 12/05 PDF
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 PDF
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 PDF
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 PDF