NV.gov
Investigations Division
INSTRUCTIONS
To electronically complete these forms please download and edit them with Adobe Acrobat. Once complete, save the file and return it to the GCB according to the instructions on the form.
NONRESTRICTED
1. Nonrestricted Gaming License 2. Nonrestricted Gaming License as a Key Employee 3. Manufacturer and/or Distributor License 4. Manufacturer of Interactive Gaming Systems or Associated Equipment License 5. Preliminary Determination Location Suitability 6. Operator of Interactive Gaming License 7. Information Service License 8. Disseminator License 9. Conduct Racing License 10. Conduct Pari-Mutuel Wagering License 11. Approval to Participate in Pari-Mutuel Commission 12. Gaming Salon License 13. Approval to Grant an Option 14. Operate a Call Center
REGISTRATION
1. Minority Equity Owner 2. Independent Testing Lab Registration 3. Associated Equipment NEW Registration 4. Associated Equipment RENEWAL Registration 5. Independent Host NEW Registration 6. Independent Host RENEWAL Registration 7. Independent Agent NEW Registration 8. Independent Agent RENEWAL Registration 9. Service Provider NEW Registration 10. Service Provider RENEWAL Registration 11. Hosting Center NEW Registration 12. Hosting Center RENEWAL Registration 13. Registered Hosting Center Requesting Additional Facility and Services 14. Hosting Center Facility and Services Requirements 20. Enrollment as an Agent (rev 8-20)
Forms and Applications
Form 1 Application For a Nevada Gaming License (Individuals) Form 1A Application for a Preliminary Finding of Suitability Form 1R Application for Registration Form 1R ADDENDUM Form 1W.1 Waiver or Modify NGC Reg 5.242(3) Form 1W.2 Waiver or Modify NGC Reg 5.231(2) or 5.240(10)(b) Form 2 Application For Approval by Corporation/Partnership/ LLC Form 3 Application For Registration by Holding Company/ Intermediary Company Form 4 Personal History Record Form 4R Personal History Record New (Registration Applications only) Form 4RR Personal History Record Renewal (Registration Applications only) Form 5R Personal Financial Questionnaire (Registration applications only) Form 6 Statement of Pre-opening Cash/First Years Cash Flow Form 7 Multi Jurisdictional Personal History Disclosure Form Form 7A Nevada Supplemental Personal History Disclosure Form Form 9 Independent Agent Yearly Reporting Guidelines Form 9 Independent Agent Yearly Report Template (EXCEL) Form 10 Affidavit of Full Disclosure Form 15 Location/Landlord Information Sheet Diagram Example - Convenience Store Diagram Example – Bar/Tavern Form 17 Release and Indemnity of All Claims Form 18 Request to Release Information Form 18R Request to Release Information (Registration Applications Only) Form 19 Application for Enrollment as an Agent Form 20 Source and Application of Funds (Restricted Gaming License only) Form 21 Application to Transfer Interest Form 27 3.015(2) Additional Requirements for Restricted Applications Form 28 Electronic Fingerprint Receipt Electronic Fingerprint Instruction Memo Approved Fingerprinting Locations Form 28A Fingerprint Background Waiver
*Sample Compliance Report
*Questions regarding the race book and/or sports pool reserve requirements should be directed to the Audit Division, Las Vegas office, at gcblvaud@gcb.nv.gov or (702) 486-2060.
Online Book Wagering Submission Process - effective 10/1/19
BWR XML specifications and mapping Access Book Wagering Forms Book Wagering Online Submission Training
Publicly Traded Corporations
Reporting Requirements Official Forms Instructions - Forms for use by Publicly Traded Corporations (05/25) PTC-1 Application (05/25) PTC-2 Application for Registration or for Amendment to Order of Registration (05/25) Form 17 Release and Indemnity of All Claims PTC-110 Application for Approval of a Public Offering (05/25) PTC-115 Application for a Continuous or Delayed Public Offering ("shelf") (05/25) PTC-200 Application for Approval of and Acquisition of Control (05/25) PTC-250 Application for Approval of a Plan of Recapitalization (05/25) PTC-260 Application for Approval of Exceptional Repurchase of Securities (05/25) PTC-310 Application for Approval of a Proxy Statement or Information Statement (05/25) PTC-430 Application for Waiver of NGC Reg. 16.430 as an Institutional Investor (05/25)