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List the organization s separate and segregated charity gaming checking account information. Name of bank Name of separate and segregated charity gaming checking account Account number IMPORTANT You must attach Form CG-21 Annual License Gross Receipts Report CG-8 Annual License Financial Report CG-INV Ending Inventory Statement CG-DIST Charitable Contribution Distribution List CG-CO Current Officer List and the license renewal fee to this application. CERTIFICATION 22. Signature of Presiding...
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