ND Documents
Homepage ⇢ Free Sfn 53859 North Dakota Template
Article Structure

The SFN 53859 form, utilized in North Dakota, serves as a critical component in the application process for individuals seeking a lottery retailer license. This document requires applicants to provide comprehensive personal information, including their Social Security number, current and previous addresses, and details about their business affiliations. It specifically targets sole proprietors, corporate directors, and general managers, ensuring that those primarily responsible for financial affairs are thoroughly vetted. The form also mandates disclosure of any prior names used, which is essential for conducting accurate background checks. A significant aspect of the SFN 53859 is its emphasis on the applicant's residential history over the past five years. If the applicant has lived outside of North Dakota, the Office of Attorney General will initiate a record check in those states, potentially incurring additional fees and requiring specific documentation. This process underscores the form's role in maintaining the integrity of the lottery system by enabling a thorough investigation into the applicant’s criminal history and financial background. Moreover, the form includes a privacy act notification, clarifying the use of the Social Security number and the implications of non-disclosure. Ultimately, the SFN 53859 is a vital tool in ensuring that only qualified individuals are granted the privilege of operating as lottery retailers in North Dakota.

Key takeaways

When filling out the SFN 53859 form for North Dakota, keep these key takeaways in mind:

  • Purpose: This form is used for record and credit checks as part of the Lottery Retailer License Application process.
  • Personal Information: Be prepared to provide your name, Social Security Number, and various addresses.
  • Previous Names: If you have used any other names, including maiden names or nicknames, list them in the designated section.
  • Residency History: You must disclose if you have lived in any state other than North Dakota in the past five years.
  • Out-of-State Checks: If applicable, you will need to pay additional fees and submit required documentation for record checks from other states.
  • Authorization: Your signature on the form authorizes the Office of Attorney General to investigate your criminal history and credit information.
  • Social Security Number: Providing your Social Security Number is voluntary, but it is necessary for conducting thorough checks.
  • Fees: There is a fee of $15 for the record check, which must be submitted with the application.
  • Office Use Only: The form includes sections for office use, where results of the checks will be recorded.

Completing this form accurately and thoroughly is essential for the processing of your lottery retailer license application.

Document Characteristics

Fact Name Description
Form Purpose The SFN 53859 form is used to conduct record and credit checks for individuals applying for a lottery retailer license in North Dakota.
Governing Laws This form is governed by North Dakota Century Code (N.D.C.C.) sections 53-12-13 and 53-12-14, as well as North Dakota Administrative Code (N.D.A.C.) section 10-16-02-03.
Submission Requirement Applicants must submit this form alongside their Lottery Retailer License Application to initiate the background check process.
Privacy Act Notification The form includes a Privacy Act Notification, indicating that providing a social security number is voluntary but necessary for conducting thorough background checks.
Fee for Out-of-State Checks If an applicant has lived in states outside of North Dakota in the last five years, they may incur additional fees for out-of-state record checks as outlined in the form.

Dos and Don'ts

When filling out the SFN 53859 North Dakota form, attention to detail is crucial. Here are some important do's and don'ts to ensure a smooth application process.

  • Do type or print clearly to avoid any misunderstandings.
  • Do provide accurate information, especially regarding your Social Security number and previous names.
  • Do check all details for accuracy before submitting the form.
  • Do ensure you submit the form along with the Lottery Retailer License Application.
  • Don't leave any required fields blank; incomplete forms may be rejected.
  • Don't provide false information, as this can lead to legal repercussions.
  • Don't forget to include any necessary documentation for out-of-state record checks if applicable.
  • Don't overlook the signature requirement; an unsigned form will not be processed.

Documents used along the form

The SFN 53859 form is an essential document for individuals applying for a lottery retailer license in North Dakota. Along with this form, several other documents and forms are often required to ensure a complete application process. Below is a list of related forms that may be necessary, each serving a specific purpose in the licensing journey.

  • Lottery Retailer License Application: This is the primary application form that provides detailed information about the applicant's business and intentions to operate as a lottery retailer.
  • Out-of-State Record Check Authorization and Release: If the applicant has lived in other states within the past five years, this form authorizes those states to provide criminal history records to the North Dakota Office of Attorney General.
  • Employment Verification Form: When verifying employment status, consider the essential Employment Verification form resources to ensure accuracy and reliability in your assessments.
  • Background Investigation Consent Form: This document allows the Office of Attorney General to conduct a thorough background check on the applicant, ensuring compliance with state regulations.
  • Financial Disclosure Statement: This form requires the applicant to disclose financial information, which helps assess their eligibility and stability to operate a lottery business.
  • Credit Check Request Form: For sole proprietors, this form is necessary to authorize a credit check, which is part of the evaluation process for the lottery retailer license.
  • Business License Application: Depending on the business structure, this form may be needed to obtain a general business license from the state or local authorities.
  • Tax Identification Number Application (Form SS-4): This form is used to apply for an Employer Identification Number (EIN) from the IRS, which is often required for business operations.
  • Affidavit of No Criminal Conviction: This affidavit is a sworn statement confirming that the applicant has no criminal convictions that would disqualify them from obtaining a lottery retailer license.

Each of these forms plays a crucial role in the application process, ensuring that the applicant meets all necessary requirements. Completing them accurately and submitting them alongside the SFN 53859 form can help facilitate a smoother licensing experience.

Different PDF Templates

Nd Tax Forms - Understanding tax classifications will assist in proper completion of the F10 form.

When engaging in the sale of an All-Terrain Vehicle (ATV) in California, it's crucial to utilize the proper documentation, such as the California ATV Bill of Sale form, which can be easily accessed at TopTemplates.info. This form ensures clarity and protects the interests of both the buyer and the seller by detailing the terms of the sale and facilitating a smooth transfer of ownership.

North Dakota Income Tax Calculator - Using the T 12 not only fulfills a legal requirement but also supports state infrastructure through taxation.