Gambling Equipment at Tradeshows

Name of the tradeshow: *

Physical address of tradeshow: *

Dates of tradeshow: *

Start Date

Month

Day

Year

End date of tradeshow: *

End Date

Month

Day

Year

Name of licensed manufacturer/distributor transporting the equipment into Washington: *

License number of manufacturer/distributor transporting the equipment into Washington: *

Equipment type: *

Other - please specify: *

Equipment quantity: *

Gambling activity type: *

Has this equipment been approved by WSGC? *

Yes

No

Equipment manufacturer: *

Equipment manufacturer's license number: *

Equipment model name and version number: *

Name of person responsible for equipment: *

Phone number: *

Email (optional):

Dates equipment will enter and leave the state (if not yet approved), in compliance with WAC 230-16-005: *

Entry Date

Month

Day

Year

Date equipment will leave the state: *

Exit Date

Month

Day

Year

Physical address where equipment will be stored before and after the trade show (if unapproved): *

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Gambling Equipment at Tradeshows

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