N.H. Admin. Code § Lot 301.01

Current through Register No. 50, December 12, 2024

Section Lot 301.01 - Required Information

Each applicant wishing to become a sales agent of the commission shall complete and submit the following as part of the application approval process to the New Hampshire lottery commission "(commission)":

(a) The "Sales Retailer Application" dated January 06, 2009.

(b) The "Retailer Agreement for Sale of New Hampshire Lottery Tickets" shall contain at a minimum the following:

(1) The effective date of the agreement between the commission and the name of the New Hampshire lottery games retailer (retailer);

(2) Signatures of the owner and lottery director, along with their printed names and date(s) the agreement was signed; and

(3) Signature and date of witness to agreement signing.

(c) The "Board of Directors Member Listing" dated October 28, 2013 shall be completed by all business structures licensed by the commission including sole Proprietorships, Partnerships, corporations, Limited Liability Companies and non-profit Corporations.

(d) Each individual listed on the "Board of Directors Member Listing" shall submit the following personal data on the application including name, address, social security number, date of birth, home phone number, cell phone number, and previous address (if living at current address less than 5 years), along with their signature, a criminal record release authorization form, and a copy of a photo identification.

(e) The "State of New Hampshire Alternate W-9 Form" shall contain at a minimum the following information:

(1) Name of the business;

(2) Address of the business;

(3) Taxpayer Identification Number (TIN) as used on Internal Revenue Service tax return;

(4) Principal activity of the type of service or product provided;

(5) Designation of business structure which applies to the organization as provided to the Internal Revenue Service; and

(6) Name and title of individual completing the form, along with his/her contact numbers and signature.

(f) The "Criminal Record Release Authorization Form" shall:

(1) Be completed by each applicant or partner of the applicant including an owner, partner, member, manager or officer of the business structure listed on the "Board of Directors-Member Listing" and on the "Sales Retailer Application"; and

(2) Contain at a minimum the following:

a. Name;

b. Address;

c. Date of birth;

d. Hair color;

e. Eye color;

f. Sex;

g. Driver license number; and

h. Signature notarized and date signed.

(g) The "Authorization Agreement for Variable Withdrawals (ACH-Automated Clearing House Debits)" required for weekly Electronic Fund Transfers (EFTs) shall contain at a minimum the following:

(1) Name of business;

(2) Tax ID number;

(3) Name on checking account;

(4) Signature of authorizing party;

(5) Date;

(6) Address of business; and

(7) Agent number.

(h) Copy of voided check, or bank verification if savings account.

N.H. Admin. Code § Lot 301.01

#83, eff 12/18/1978; ss by #1542, eff 3/24/1980; EXPIRED: 3/24/1986; New. #6551, eff 7/29/1997, EXPIRED: 7/29/2005; New. #8435, INTERIM, eff 9/21/2005, EXPIRED: 3/20/2006; New. #8610, eff 4/16/2006, EXPIRED: 4/15/2014; New. #10717, eff 11/19/2014; ss by #10942, eff 10/2/2015 (See Revision Note at chapter heading for Lot 300).