Colorado Secretary of State - Commercial Landlord License

Registration year

*This registration is for

Landlord's information

Enter the landlord entity name as it appears on the records of the Secretary of State.

*Name

Street

*Address 1

Address 2

*City

*State

*ZIP / Postal code

Province

*Country

Mailing

Address 1

Address 2

City

State

ZIP / Postal code

Province

Country

*Phone

*Email

Premises

Enter the address where the license will be used.

Street

*Address 1

Address 2

*City

*County

State

*ZIP code

Registered agent

If Landlord is not a Colorado resident, a Colorado registered agent is required.

Owners

If the organization is a corporation, partnership, limited liability company, association or other business entity, list each

shareholder,
officer,
director,
partner,
member,
manager
or other individual

who has an ownership interest of ten percent (10%) or more in the organization. If there are no individuals with ownership interests of 10% or more, you can click on Continue to move on.

Add an owner

Attachments

You must attach:

A plan or blueprint of the facility to be rented and its dimensions,
A copy of the lease or deed to the premises,
Copies of:
- zoning,
- building,
- fire safety, and
- other clearances or permits for the use of the premises as a commercial bingo facility.
An explanation of any conviction that occurred more than 10 years ago for a
- felony,
- theft by deception, or
- gambling-related offense.
Include details about the facts and circumstances. This applies to owners, officers, directors, partners, members, or associates.

Documents must be attached here in order to include them in your registration - documents are not accepted on paper.

You can attach .jpg, .gif, .png, or .tif image files, or PDF files.

Multiple files can be uploaded. Combined size of all files must be 4 MB or less. 1 MB = 1024 KB

Add a file

Filer's information

I solemnly affirm under penalty of perjury as defined in §18-8-503 and punishable by law that I am either the applicant or the chief executive officer of the applicant herein.

I have read and am familiar with the provisions of Title 24, Part 6, Colorado Revised Statutes (C.R.S.), also known as the Bingo and Raffles Act, with respect to commercial bingo facilities and landlords thereof and I accept responsibility for the applicant’s compliance with those provisions. Neither the applicant nor any of its owners, officers, directors, partners, members or associates has been convicted of any felony, theft by deception, or gambling-related offense, as defined in Title 18, Article 10 C.R.S., within the previous ten years. I have read and know the contents of this application and the statements, attachments, and other materials included with or in it, and all matters set forth herein are true and complete.

*First

Middle

*Last

Suffix

*Address 1

Address 2

*City

*State

*ZIP / Postal code

Province

*Country

*Phone