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County/City Lottery Forms
Printing Instructions
Many of the files below are in Adobe Acrobat format. Selecting a file will load it into the Acrobat Reader, which will allow you to print it. If you have trouble downloading or printing, you probably need to install or upgrade your Acrobat Reader.
Install the Acrobat Reader if you do not yet have it installed on your computer.
Some of these forms are available in a "Fill-able" format, meaning you can view, complete, and print the form on your computer. These forms use the features provided with Adobe Acrobat. Currently, there is no validation or verification of the information you enter, and you are responsible for entering and checking all required information. Instructions may require some information to be handwritten on the form (signatures, for example). Note: The Acrobat Reader does not allow you to save your completed forms. You should print two copies -- one to mail, and one to keep for your records.
If you experience problems with downloading forms, it is recommended that you upgrade to the latest version of Adobe Reader. Please note that the "Fill-able" forms are a larger file size and will take longer to download. |
Applications:
| Beginning October 1, 2009, all new license applications for lottery (keno) workers, sales agents, gaming managers, and utilizations of funds members must include an attestation form confirming United States citizenship or lawful presence. This requirement is mandated by LB 403 (2009). The Attestation Form can be downloaded here |
- Licensing Checklist
- Form 50G, Nebraska Application for County/City Lottery
- Form 50G, Schedule I, County/City Lottery Operator Application
- Form 50G, Schedule II, County/City Lottery Sales Outlet Location Application
- Form 50G, Schedule III, County/City Lottery Worker Application
- Update: Form 50G - Nebraska Schedule III, County/City Lottery Worker Application has been revised to include the United States Citizenship or Lawful Presence Attestation. A separate Attestation Form will not be required with the new Nebraska Schedule III. The new application can be downloaded from the website and is also available in a fill-in format. The new Nebraska Schedule III may still be ordered from Charitable Gaming; however, it will no longer be provided in a three-part carbonless format. You will have to make copies for the license applicant and the applicable county, city, or village.
- Form 50A, Nebraska Application for Manufacturers, Distributors, and Manufacturer-Distributors
- Instructions for Completing Fingerprint Application
- Instructions for Completing 2010-2012 County/City Lottery License Renewal Application
Reporting Forms:
Miscellaneous Forms:
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