Sfn 53859 North Dakota Template
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The SFN 53859 form, used in North Dakota, plays a crucial role in the lottery retailer licensing process. This form is essential for individuals and businesses seeking to operate as lottery retailers within the state. It facilitates a comprehensive record and credit check by the Office of Attorney General, ensuring that applicants meet the necessary eligibility criteria. The form requires personal information, including the applicant's name, Social Security number, and addresses, which are vital for conducting background checks. Additionally, it prompts applicants to disclose any previous names and details about their residency over the past five years. This is particularly important, as the Office may need to reach out to other states for further record checks, which could incur additional fees and require specific documentation. The form also includes an authorization section, where applicants confirm the accuracy of their information and grant permission for the Office to investigate their criminal history and financial background. Privacy is a key consideration, as the form outlines the voluntary nature of providing the Social Security number, while also explaining its necessity for processing the application. Overall, the SFN 53859 form is a vital tool that helps maintain the integrity of the lottery system in North Dakota by ensuring that only qualified individuals are granted licenses to sell lottery tickets.
Sample - Sfn 53859 North Dakota Form
Document Specs
| Fact Name | Details |
|---|---|
| Form Purpose | This form is used to conduct a record and credit check for individuals applying to become lottery retailers in North Dakota. |
| Governing Laws | The form operates under 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 along with their Lottery Retailer License Application to initiate the background check process. |
| Social Security Number | The form requests a social security number to facilitate criminal history and credit checks. Providing this number is voluntary but may affect application processing. |
| Previous Residences | If the applicant has lived outside North Dakota in the last five years, they must list those states. The Attorney General's office will request record checks from those states. |
| Fees for Out-of-State Checks | Applicants may incur additional fees for out-of-state record checks, as specified in the "Fee Schedule for Out-of-State Record Checks." |
| Authorization | By signing the form, the applicant authorizes the Office of Attorney General to investigate their criminal history and financial information, as applicable. |
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