Nevada > Statewide > Nevada Gaming Commission And State Gaming Contol Board > Investigations Division
Source And Application Of Funds (For Restricted Gaming License) 20 - Nevada
| Source And Application Of Funds (For Restricted Gaming License) Form. This is a Nevada form and can be used in Investigations Division Nevada Gaming Commission And State Gaming Contol Board Statewide . |
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SOURCE AND APPLIC ATION OF FUNDS (For a Restricted Gaming License) Name of gaming location Date If the gaming location will be a new business, or has been opened/acquired within the last 12 months, this form must be submitted with your application. A. Funds available prior to opening: 1. Personal funds (attach schedule provide documents evidencing the source and availability of personal funds being invested)................$ 2. Loans from lending institutions (attach schedule provide loan documents).............................................................................................. 3. Loans from individuals and business entities (attach schedule identify the individual or business and provide loan documents)............. 4. Loans from slot route operators (attach related documents ) ................ 5. Other forms of investment (attach schedule provide detail including sources and amounts).............................................................................. Total funds available prior to opening ..................................................(A) B. Expenditures or other disposition of available funds prior to opening: 1. Prepaid gaming taxes and licenses.......................................................$ 2. Other license fees (such as business license, liquor license, and investigative fees).................................................................................... 3. Expenditures for: (a) Real property and buildings (include construction and repair) ........... (b) Business purchase price ( attach purchase agreement ) .................. (c) Remodeling costs............................................................................... (d) Equipment.......................................................................................... (e) Inventory and supplies....................................................................... 4. All other pre-opening expenditures (such as salaries, advertising, deposits, etc.)........................................................................................... Attach schedules giving brief description of items 1, 2, 3, and 4. Total pre-opening cash used......................................................................(B) C. Cash available for operation (A minus B)........................................................$ Form 20 Source and Application of Funds (Rev. 05/04)
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