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INSTRUCTIONS: ARIZONA ENDORSEMENT BY LOCAL GOVERNING BODY (Form 71-1002)

As part of the Arizona bingo license application process, a form 71-1002 must be submitted documenting endorsement from your local governing body. This document can be obtained from the website of the Arizona Department of Revenue.

Arizona Endorsement By Local Governing Body 71-1002 Step 1: Indicate with a check mark if this is a new application or one documenting a change of location.

Arizona Endorsement By Local Governing Body 71-1002 Step 2: In the first two blank boxes, enter your license number and the date.

Arizona Endorsement By Local Governing Body 71-1002 Step 3: In the next blank box, enter the name of the local governing body.

Arizona Endorsement By Local Governing Body 71-1002 Step 4: In the next blank box, enter the street number or P.O. box of the local governing body.

Arizona Endorsement By Local Governing Body 71-1002 Step 5: In the next blank box, enter the telephone number of the local governing body.

Arizona Endorsement By Local Governing Body 71-1002 Step 6: In the next blank box, enter the city, state and zip code of the local governing body.

Arizona Endorsement By Local Governing Body 71-1002 Step 7: On line 1, enter the date on which your hearing was conducted.

Arizona Endorsement By Local Governing Body 71-1002 Step 8: Indicate with a check mark whether the hearing concerned a hearing for a bingo license or for a bingo license location transfer.

Arizona Endorsement By Local Governing Body 71-1002 Step 9: On line 2, enter the name of the applicant.

Arizona Endorsement By Local Governing Body 71-1002 Step 10: On line 3, enter the location or address where games will be conducted.

Arizona Endorsement By Local Governing Body 71-1002 Step 11: On line 4, enter the days and times on which games will be conducted.

Arizona Endorsement By Local Governing Body 71-1002 Step 12: On line 5, indicate with a check mark whether background investigations have been conducted on all individuals listed on the Bingo License Application.

Arizona Endorsement By Local Governing Body 71-1002 Step 13: On line 6, indicate with a check mark whether you recommend the application be approved or disapproved.

Arizona Endorsement By Local Governing Body 71-1002 Step 14: On line 7, enter any specific reasons you have for your recommendation. Sign and date the form where indicated.