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Regulation 14.180 Application - Licensed Manufacturers And Distributors Forms - Nevada

Regulation 14.180 Application - Licensed Manufacturers And Distributors Forms Form. This is a Nevada form and can be used in Enforcement Division Nevada Gaming Commission And State Gaming Contol Board Statewide .
 Fillable pdf Last Modified 4/16/2007
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American LegalNet, Inc. www.USCourtForms.com 14.180 APPLICATION Addendum MANUFACTURER 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (CT=Currency Type(F-T-U-M-O),TT=Transaction Type (S-L-V)) American LegalNet, Inc. www.USCourtForms.com YEAR DESCRIPTION SERIAL # MODEL # SELLER ID DENOM. CT PRICE TT PURCHASER'S STATEMENT I, ______________________________, declare under penalty of perjury that each gaming device, as identified more fully on the attached Regulation 14.180 Application, will be used only for lawful purposes, specifically _________________________________________________ ___________________________________________________________ __________________________________________________________. (describe intended use) I acknowledge that all subsequent distribution of these devices must conform to all local, state, federal and foreign laws. _____________________________________________ Print Name _______________________________________ _________________ Signature of Purchaser Date American LegalNet, Inc. www.USCourtForms.com
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