Free State Form 46456 (1-94) - Indiana

INDIANA GAMBLING GAME LICENSE APPLICATION

THIS APPLICATION MAY ONLY BE COMPLETED AND SUBMITTED BY A HORSE RACING PERMIT HOLDER. SEE IC 4-35-5.

Disclosure of this information is REQUIRED. The Indiana Gaming Commission may require Applicants to disclose additional information not covered by this application. Failure to provide information could result in rejection or delay the processing of this application.
State Form 53554 (3-08)

Approved by State Board of Accounts, 2008

INSTRUCTIONS FOR GAMBLING GAME LICENSE APPLICATION FORM APPLICANT FOR A GAMBLING GAME LICENSE IS SEEKING A PRIVILEGE. THE BURDEN OF PROVING ITS QUALIFICATIONS TO RECEIVE SUCH A LICENSE IS AT ALL TIMES ON APPLICANT. APPLICANT MUST ACCEPT ANY RISK OF ADVERSE PUBLIC NOTICE, EMBARRASSMENT, CRITICISM, OR OTHER ACTION, OR FINANCIAL LOSS WHICH MAY RESULT FROM ACTION WITH RESPECT TO AN APPLICATION, AND EXPRESSLY WAIVES ANY CLAIM FOR DAMAGES AS A RESULT THEREOF. INFORMATION NOT CALLED FOR IN THIS APPLICATION OR IN ADDITION TO THAT PROVIDED IN RESPONSE TO THIS APPLICATION MAY BE REQUESTED. APPLICANT SHALL PROVIDE ALL INFORMATION, DOCUMENTS, MATERIALS AND CERTIFICATIONS AT APPLICANT'S SOLE EXPENSE AND COST. The total cost of the investigation conducted pursuant to this application shall be borne by Applicant. In addition, Applicant is responsible for the payment of all application and license fees required under or IC 4-35 and the posting of the bond required under or IC 4-35. Applicant should respond to the questions contained in this application to the best of its knowledge. Any misrepresentation or omission is grounds for application denial. Applicant is under a continuing duty to disclose promptly any changes in the information provided in the application and requested materials submitted to the commission. The duty to make additional disclosures continues throughout any period of the licensure granted by the commission. Type the answers to all questions. If the answer or material responsive to a question has been provided in response to another portion of the application, refer to the other portion. The male pronoun when used in this application includes the masculine and feminine and neuter and also the plural, as appropriate. A. FORMS AND DOCUMENTS One (1) bound original and one (1) unbound, unstapled copy of the application must be submitted by Applicant, labeled with Applicant's name, along with the following information if applicable: 1. 2. 3. 4. Exhibits and schedules. Applicant's consent to release information. Release of all claims. Affidavit of full disclosure.

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5.

Verification.

B. DEFINITIONS Capitalized terms in this Application shall have meanings ascribed to them in IC 4-33-2, IC 4-352 and/or 68 IAC 1-1, unless otherwise specified herein. If there are conflicts among definitions in these code sections, the definition IC 4-35-2 prevails. The following capitalized terms shall have the following meanings: Acts: Indiana Code 4-33 and Indiana Code 4-35. Applicant: Any individual or Business Entity who directly or indirectly has applied for a Gambling Game license. Casino: Gaming facility within the jurisdiction of the commission under IC 4-35. Casino Gambling Operation: The conducting of Gaming and all related activities, including, without limitation, the purveying of food, beverages, retail goods and services, and transportation on a Casino and at its support facilities. Key Person: Any officer, director, executive, employee, trustee, substantial owner, independent contractor, or Business Entity having the power to exercise management or operating authority over a Business Entity or affiliate(s) thereof. Substantial Owner: any person holding five percent (5%) or more ownership interest in a Business Entity, or any institutional investor holding fifteen percent (15%) or more ownership interest in a Business Entity. Supplier: Any person or entity required to hold a supplier's license under 68 IAC 2-2-1(c).

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TRANSMITTAL LETTER EXECUTIVE DIRECTOR INDIANA GAMING COMMISSION South Tower, Suite 950 115 W. Washington Indianapolis, IN 46204-3408 Dear Sir: ______________________________________________ does herewith make application (Applicant's Name) to conduct a Casino Gambling Operation in _________________________________________. (City or County) The Applicant agrees to disclose and to require all of the persons associated with the Applicant to disclose all information, documents and other material which the Indiana Gaming Commission may request at any time. Further, the Applicant agrees to furnish any additional information, documents and other material requested by the Indiana Gaming Commission, and agrees that such additional material shall be made a part of this application. The Applicant acknowledges that neither the acceptance of this application nor the issuance of a license implies that the Indiana Gaming Commission admits the truth of the statements made in this application, or its approval of the statements. The acceptance or the issuance of a license shall not constitute waiver or agreement by the Indiana Gaming Commission with respect to any material contained in the application or supplement to application. The Applicant further acknowledges that any license or any interest in any license issued by the Indiana Gaming Commission is not transferable, and that subsequent legislation, rule, or action by the commission may diminish the value of any license issued by the Indiana Gaming Commission to any extent possible. Respectfully submitted,

______________________________ Applicant's Name

By: __________________________ Print Name and Title Date: ________________________ (month, day, year)

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INDIANA GAMBLING GAME LICENSE APPLICATION
1. Name of Applicant Doing Business As

THIS FORM MUST BE TYPED

_____________________________________________________________________________________________ Business address (Do not enter a P.O. Box) _____________________________________________________________________________________________ City State Zip Code Telephone Number _____________________________________________________________________________________________ Federal Identification Number Indiana Taxpayer Identification Number _________________________________________________________________________________________ Social Security Number (if sole proprietor) _____________________________________________________________________________________________ Mailing Address _____________________________________________________________________________________________ City State Zip Code Fax Number _____________________________________________________________________________________________ Attorney representing the Applicant before the Commission Name Business Address Fax Number Telephone Number _____________________________________________________________________________________________ Contact Person (if different from above) Name Business Address Fax Number Telephone Number _____________________________________________________________________________________________ Check the type of organization: Corporation Individual Fiduciary Limited Liability Company Association Sole Proprietorship Other Business Entity ___________________

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GENERAL BUSINESS
2. (a) Submit as Exhibit 2(a) a detailed description of Applicant's business, including the background and skills of Applicant, and identifying and describing any predecessor company of Applicant. Submit as Exhibit 2(b) a list of all current and former addresses which Applicant has held or from which it has conducted business within ten (10) years from the date of filing this application, including the approximate time periods during which such addresses were held.

(b)

3.

If Applicant does business outside Indiana, submit as Exhibit 3 a statement listing all other jurisdictions where Applicant does business, describing the business activity conducted in those other jurisdictions, and listing all addresses from which Applicant currently does business. If none, initial here______________

4.

Submit as Exhibit 4 a schedule listing the name, business address and telephone number of Applicant's Indiana and out-of-state: · · · · registered agent(s); legal services representatives; accounting services representatives; and banking and financial services representatives. Submit as Exhibit 5(a) the name of the business, the state of incorporation, the date of incorporation, the percent ownership, and type of equity in any other Business Entity in which the Applicant or the spouse or children of an Applicant owns at least a one percent (1%) interest. Submit as Exhibit 5(b) a statement setting forth for each Business Entity in which stock is held by or on behalf of Applicant: · · · · · · the name, address and telephone number of each company; the class of stock held; the purchase price per share; the current market value per share; the number of shares held; and the percentage of ownership. If none, initial here______________

5.

(a)

(b)

6.

If Applicant is a Corporation, submit as Exhibit 6 the following: (a) the name, including all former and assumed names, and the address of the 6

corporate headquarters. In addition, also submit the FIN of any federal tax stamp numbers for transporting Gaming equipment held by Applicant; (b) the state in which Applicant is incorporated, the date of incorporation, and, if a corporation is not incorporated in Indiana, whether the corporation is authorized to conduct business in Indiana; for the present and former officers, Key Persons, and Substantial Owners of each corporation, their names, and positions during the three (3) years prior to the filing of this application; detail: · · · · · · · the classes of stock and number of shares; the number of shares authorized, issued, or outstanding; the par value and market value of shares; the voting rights per class of share (if the right of holders of any class of stock may be modified otherwise than by a vote of a majority or more of the outstanding shares so affected, voting as a class, so state and briefly explain); the exchange, if any, on which any class of stock may be traded; a list of names, addresses and numbers of shares held or all holders of outstanding shares; and a list of stock certificates that have been or will be pledged and the name, address and telephone number of the pledgor and pledgee of any such stock certificates in a corporation that is not a publicly held company. If none, initial here______________ 7. If Applicant is a Partnership, submit as Exhibit 7 the following: (a) the name, including all former and assumed names, and the address of the corporate headquarters. In addition, also submit the FIN of any federal tax stamp numbers for transporting Gaming equipment held by Applicant; a statement setting forth for each partner: · · · · (c) the amount of initial investment, whether in the form of cash, negotiable instruments, property or otherwise; the amount and nature of any anticipated future investments; the degree of control over the activities of the partnership; and the method of distributing partnership profits.

(c)

(d)

(b)

for the present and former officers, Key Persons, and Substantial Owners of each corporation, their names, and positions during the three (3) years prior to the filing of this application. If none, initial here______________ 7

8.

If Applicant is any other Business Entity, submit as Exhibit 8 the following: (a) the name, including all former and assumed names, and the address of the corporate headquarters. In addition, also submit the FIN of any federal tax stamp numbers for transporting Gaming equipment held by Applicant; a detailed description of the organization of each Business Entity for each Business Entity that is not organized under Indiana law, a statement identifying the law under which it is organized and stating whether it is authorized to conduct business in Indiana. the name and address of each participant in each Business Entity that is a general or limited partner, unincorporated associate, or other Business Entity detail: · · · · (f) the amount of initial investment, whether in the form of cash, negotiable instruments, property or otherwise; the amount and nature of any anticipated future investments; the degree of control over activities; and the method of distributing profits.

(b) (c)

(d)

(e)

for the present and former officers, Key Persons, and Substantial Owners of each corporation, their names, and positions during the three (3) years prior to the filing of this application. If none, initial here______________

9.

Submit as Exhibit 9(a) through 9(t), as applicable, copies of the following documents if applicable: (a) (b) (c) (d) (e) (f) (g) (h) (i) (j) (k) (l) (m) (n) partnership agreement; trust agreement; joint venture agreement; certified copies of the articles of incorporation or corporate charters, and amendments thereto of Applicant and its affiliated companies; a certificate of good standing of the state of incorporation of Applicant; a certificate of good standing issued by the Indiana Secretary of State indicating Applicant is qualified to do business in the State of Indiana; articles of association; by-laws; other legal instrument of organization; contracts, leasing or rental agreements, or other agreements relating to Gaming; debt instruments; non-Gaming agreements or contracts exceeding $20,000; non-Gaming lease agreements that have an annualized rental exceeding $20,000; purchase/sale agreements for any mergers with and/or acquisitions of any Business Entity in the last ten (10) years; 8

(o) (p) (q) (r) (s) (t)

management contracts; employment contracts with Key Persons and Substantial Owners; stock bonus or profit sharing plans; shareholders' agreements; organizational charts, including job descriptions and the names of individuals holding such positions; and share certificates (both sides of any Business Entity held by or on behalf of Applicant).

10.

Submit as Exhibit 10 the name, address, and the percent of ownership of every individual or Business Entity having a greater than 1% direct or indirect pecuniary interest in Applicant's proposed Casino. Provide an ownership chart, including percentage interest of all Key Persons and Substantial Owners of Applicant illustrating the ultimate owners/real parties in interest. Provide an organization chart of the Applicant illustrating its operations and the identity of the individuals/Business Entities responsible for performing the various operations. (a) If the beneficial owner of any stock in each corporation is an Individual or Business Entity other than the owner of record or subscriber, the name and address of the owner of record or subscriber, the name and address of the beneficial owner, the conditions under which the owner of record or subscriber holds and votes or has subscribed for such stock; submit as Exhibit 13(a) a copy of any contract or other instrument relating to said conditions (Note: If a publicly held company, submit information only for those holding 5% or more interest); If within five (5) years from the date of filing this Application there has been a change in the beneficial ownership of the equity securities of a corporation, including changes resulting from gift, purchase, sale, exercise of an option to purchase or sell, or grant or receipt of a put or call, on the part of any Individual or Business Entity who is or was a direct or indirect beneficial owner of 10% or more of any class of an equity security of the corporation, or who is or was a Key Person of the corporation, for each change of ownership state: (1) (2) (3) (4) (c) the date of transaction; the nature of transaction; the parties, including their position, to the transaction; and the number, class and percentage of ownership of securities involved; and

11.

12.

13.

(b)

A description for each corporation of all stock warrants, options or common stock equivalents that are authorized, issued and exercisable, including applicable lists of participant names.

14.

Submit as Exhibit 14 a statement setting forth the names, addresses and telephone numbers of all of Applicant's proposed Support Facility owners, and Suppliers. If the mailing address is a P.O. Box, give that address plus the street address of the location.

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15.

Submit as Exhibit 15(a) and 15(b), as applicable, statements setting forth the following for the proposed Gaming Operations Manager, Support Facility owners, Suppliers, and the holders of any Debt Instrument of Applicant: (a) (b) a detailed description of the relationship with the Applicant: a detailed description of any transaction in the last five years, or contemplated in the future with the Applicant.

The Commission may at any time request documents relating to the transactions detailed in Exhibit 16. 16. Submit as Exhibit 16 the Applicant's plan for utilizing Minority Business Enterprises and Women's Business Enterprises, including Applicant's plan for attaining the goals relating to such Enterprises which are required under IC 4-35.

GAMING
17. Does the Applicant possess a Gaming-related license issued by any jurisdiction? Answer:___________ If the answer is "yes", submit as Exhibit 17(a) one (1) copy of each license. Submit as Exhibit 17(b) a statement detailing whether Applicant has ever had a Gaming related license denied, suspended, or revoked or if there is any pending proceeding that could lead to any of these conditions. 18. Submit as Exhibit 18 the following: (a) (b) (c) (d) (e) (f) (g) a diagram of the current site; a diagram of the proposed site; marketing plans, when available, and any market studies upon which the plans were based; the anticipated annual adjusted gross receipts, including average win per machine per day, for the first five (5) years of operations; the anticipated annual admissions for the first five (5) years of operations; the anticipated number of gaming employees; and the plan for placement of Commission agents, including square footage allocated to the Commission, confirmation that the assigned areas will be easily accessible to the gaming floor, provisions for security and the storage of evidence and the number and location of assigned parking places.

19.

Submit as Exhibit 19 a detailed description of the Gaming Area, including a detailed description of the physical layout of the Gaming Area and other activity areas at the Casino, and the restroom facilities and medical facilities available to patrons. Submit 10

images or diagrams where available. 20. Submit as Exhibit 20 a statement confirming that the Casino: (a) (b) is accessible to disabled persons; is fully registered and licensed in accordance with all applicable laws. Submit certified copies of all safety certificates, registrations and licenses issued in connection with each Casino; will be connected to the Applicant's racetrack facilities.

(c) 21.

To the extent they have been identified, submit as Exhibit 21 a statement disclosing the name, address and telephone number of each Supplier which will provide Gaming Equipment or Gaming Equipment maintenance or repair services to the proposed Casino and listing the Gaming Equipment which will be purchased, leased or rented from, or the type of maintenance or repair services to be provided by each Supplier. Submit as Exhibit 22 a detailed statement concerning the Applicant's (including all Key Persons) and Casino Operations Manager's experience and expertise in developing and managing Casino Gambling Operations. Attach all materials and documents, including resumes. If none, initial here______________

22.

FINANCIAL
23. If Applicant is a publicly held company, submit as Exhibit 23 copies of any state or federal registration statements and any other documents filed within the last three (3) fiscal years, including without limitation proxy or information statements filed pursuant to Section 14 of the Securities Exchange Act of 1934, Annual Reports (Form 10K), Quarterly Reports (Form 10Q), Periodic Reports (Form 8K), and statements prepared in accordance with Regulation S-X, under the Securities Act of 1933, the Securities Exchange Act of 1934, the Public Utility Holding Company Act of 1935, or the Investment Company Act of 1940. If none, initial here______________

24.

State whether Applicant, or any Business Entity in which Applicant has held an ownership interest, has ever been: (a) (b) delinquent in the payment of, or in dispute over the filings concerning or the overpayments of,

any tax required under federal, state or municipal law.

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Answer:_______ If the answer is "yes", submit as Exhibit 24 (a) and/or (b) a detailed statement describing the delinquency or dispute, including the amount, type of tax, taxing agencies, time periods involved, and date resolved. 25. If any of Applicant's Substantial Owners are a Publicly Held Company, submit as Exhibit 25 for each Publicly Held Company, copies of any state or federal registration statements and any other documents filed within the last three (3) fiscal years, including, without limitation, Proxy or Information Statements filed pursuant to Section 14 of the Securities Exchange Act of 1934, Annual Reports (Form 10K), Quarterly Reports (Form 10Q), Periodic Reports (Form 8K), and statements prepared in accordance with Regulation S-X, under the Securities Act of 1933, the Securities Act of 1934, the Public Utility Holding Company Act of 1935, or the Investment Company Act of 1940. If none, initial here______________ 26. State whether any of the securities or debt offerings of Applicant have been suspended from trading or have had action taken against them by any regulatory agency. ANSWER: ___________. If the answer is "yes," submit as Exhibit 26 a detailed statement describing each suspension or action. 27. State whether Applicant has ever been involved in any formal or informal process or agreement to adjust, defer, suspend or otherwise work out the payment of any debt. ANSWER: __________. If the answer is "yes," submit as Exhibit 27 a statement setting forth all details concerning each debt and the relating formal or informal process or agreement. 28. State whether Applicant has ever had any municipal, state or federal tax returns audited or adjusted: Answer:_______ If the answer is "yes", submit as Exhibit 28 a statement describing the year, type and jurisdiction of audit or adjustments. 29. Submit as Exhibit 29 a statement setting forth Applicant's projections of the annual adjusted gross revenue from the operation of Gambling Games for the next (3) three years. Submit as Exhibit 30 a statement detailing plans for extending credit and for debt collection.

30.

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31.

Submit as Exhibit 31(a) and 31(b), as applicable, copies of the following documents for Applicant, for the last three (3) fiscal years and for the period ending one (1) month prior to the date of Application, or where such Applicant has not existed as a Business Entity in any jurisdiction for the last three (3) fiscal years, for the Applicant or any Predecessor Company to the extent that they exist for the last three (3) fiscal years: (a) financial statements and state and federal tax returns, certified or authenticated by independent certified public accountants if such certified or authenticated documents have been prepared; and management representations and lawyer's contingency letters provided to certified public accountants pertaining to certified financial audits and all reports and correspondence that pertain to the issuance of Financial Statements, managerial advisory services or internal control recommendations.

(b)

32.

Submit as Exhibit 32 a statement containing: (a) (b) (c) a list of all Debt Instruments of Applicant; a list of the names, addresses and telephone numbers of all holders of each Debt Instrument; and a list of all the amount of outstanding debt relating to each Debt Instrument.

33.

Submit as Exhibit 33 a schedule listing the accounts or instruments held by Applicant during the ten (10) year period to the date of this application from any bank, savings and loan association, credit union or other financial institution, domestic or foreign, whether such account or instrument was or is held in the name of the Applicant, a Nominee of Applicant, or was or is otherwise under the direct or indirect control of Applicant, stating for each such account or instrument: (a) (b) (c) (d) (e) (f) the name, business address and telephone number of the financial institution involved; the type of account or instrument; the account or instrument number; the rate of interest; the time period during which the account or instrument was or will be held; and the opening and current or closing balance.

34.

Submit as Exhibit 34 a detailed statement concerning the capitalization of the proposed Casino Gambling Operation, including the amount and source of debt and equity involved, and the guarantees that Applicant can offer that Applicant will be able to operate a Casino Gambling Operation during the duration of the license; submit all documents that support or contradict this statement, including surety agreements, guarantor agreements, loan commitments and agreements, a list of assets that will be used or liquidated to constitute all or part of the capitalization, appraisals, broker's market studies to support real estate values, brokerage and bank statements, and Financial Statements, certified if available. Submit as Exhibit 35 a detailed statement concerning Applicant's business plan, 13

35.

including pro forma budgets and pro forma Financial Statements, for the next five (5) years. 36. Submit as Exhibit 36 a detailed statement setting forth Applicant's projections of annual profits relating to the proposed Casino Gambling Operation. Include as part of the statement any studies, reports or other documents that support or contradict Applicant's projections for annual profits, including minimum and maximum projections along with the most likely projection. Submit as Exhibit 37 a statement describing in detail Applicant's plan for implementing the audits of financial transactions and condition of total operations. Submit as Exhibit 38 declaration pages for all of Applicant's property, casualty, or other liability insurance in connection with the Casino.

37.

38.

PERSONNEL
39. Submit as Exhibit 39 a detailed statement describing Applicant's employment plan relating to the proposed Casino, including, without limitation, the number and types of positions to be filled, identifying the training to be required for each position, identifying each position by name, required duties, and salary, identifying each position which Applicant believes will require licensing and the license required. Submit as Exhibit 40 a detailed statement describing the proposed plan for training employees, including any schools, by name, address, phone number, curriculum and years in existence, which are intended to be utilized for said training. Also include any ownership interest of the Applicant, any Key Person or Substantial Owner of the Applicant in a school to be used for training. Submit as Exhibit 41 a good faith affirmative action plan to recruit, train, and upgrade minorities in all employment classifications. Submit as Exhibit 42 a description of all compensation, bonus, profit sharing, pension, retirement, deferred compensation and similar plans in existence or to be created by or on behalf of the Applicant, including: (a) (b) (c) (d) (e) (f) (g) the title or name of the plan; the identity and address of the trustee of the plan or the person administering such plan; the material features of the plan; the methods of financing the plan; the identity of each class of person who is or will participate in the plan; the approximate number of persons in each such class; and the amounts distributed under the plan to each class of persons during the last fiscal year if the plan was in effect during that time period.

40.

41.

42.

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LEGAL
43. State whether Applicant has ever been or currently is a party to a civil proceeding (other than divorce proceedings): Answer:________ If the answer is "yes", submit as Exhibits 43(a-e) a detailed list of all cases, including bankruptcies, stating for each civil proceeding within the last (20) twenty years: (a) (b) (c) (d) (e) the names of the parties; the case number; and date of filing; the name of the court and its location; the type and nature of the case; and the number of the case disposition.

In addition, for all pending litigation, unsatisfied judgments, decrees, restraining orders, or injunctive orders, state as Exhibit 43(f-g): (f) (g) in detail all pertinent facts, including the type and amount of relief sought; and an assessment of the impact, if any, which the action may have on Applicant's proposed Casino.

44.

State whether, in the last twenty (20) years, Applicant, current and former Key Persons, and Substantial Owners, in their official capacity: (a) (b) (c) has/have been convicted of any gambling related offenses; is a member of the commission; holds/hold/held a direct, indirect or attributed ownership interest in any Business Entity which holds a license issued under the Acts, or which has applied or intends to apply for a license under the Acts. (a)_______ (b)_______ (c)_______

Answer:

If the answer to subparagraph (c) is "yes", submit as Exhibit 44(c), a detailed statement concerning the ownership and pertaining license or license application. 45. State whether Applicant, current and former Key Persons, and Substantial Owners has/have been arrested, detained, charged, indicted, convicted, pleaded guilty or nolo contendere, or forfeited bail concerning any criminal offense, allegedly committed in their official capacity for the Applicant, under the laws of any jurisdiction, either felony or misdemeanor:

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Answer:_______ If your answer is "yes", submit as Exhibit 45 a statement setting forth for each case: (a) (b) (c) (d) (e) (f) (g) the date; the names and addresses of the individuals and business entities involved: the name and location of the court, arresting agency and prosecuting agency; the case number; the offense; the disposition; and the location and length of incarceration.

STRUCTURE
46. Submit as Exhibit 46 a detailed statement describing Applicant's plan for providing food, beverages and other concessions to patrons both on the Casino and, if applicable, at any Support Facility, identifying the goods, services or equipment to be provided by each Supplier as part of the proposed Casino Gambling Operation, and identifying all operations which will require further licensing, including liquor licenses, retailer licenses, and licenses to prepare and serve food for human consumption. Include images or diagrams when available. Submit as Exhibit 47 a detailed statement describing for the Casino, Applicant's plan for security, both in the Gaming Area and other activity areas, and for internal control over Gaming. Identify and describe all surveillance equipment which will be used, and explain how the equipment will be placed and monitored. Include images or diagrams of the surveillance layout. Submit as Exhibit 48 a description of all Support Facilities involved in the proposed Casino Gambling Operation, including parking facilities, and land-based hotel and restaurant facilities, and security for the same, and identifying the Support-Facility owners. Submit as Exhibit 49 a detailed, itemized statement describing how the Applicant has or will satisfy the requirement that the Applicant's facilities or proposed facilities must include capital expenditures of at least one hundred million dollars ($100,000,000). Include images or diagrams when available.

47.

48.

49.

GOVERNMENT
50. Submit as Exhibit 50 a statement describing in detail all of Applicant's existing or applied-for grants, tax relief or low interest loans given or guaranteed by any governmental entity; submit copies of all documents evidencing each grant, relief or loan, 16

and copies of all agreements between Applicant and any governmental entity. If none, initial here______________ 51. Submit as Exhibit 51 any and all agreements written, oral, or otherwise entered into between or on behalf of the Applicant and any governmental entity or subdivision thereof in the State of Indiana as it pertains to the operation of the Casino. If none, initial here______________

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APPLICANT'S REQUEST TO RELEASE INFORMATION

TO:_____________________________________________________________________________ FROM:__________________________________________________________________________ Applicant's Name 1. Applicant hereby authorizes and requests all persons or entities to which this request is presented having information relating to or concerning Applicant to furnish such information to a duly appointed agent of the Indiana Gaming Commission, whether or not such information would otherwise be protected from disclosure by any constitutional, statutory or other legal privilege. 2. Applicant hereby authorizes and requests all persons or entities to which this request is presented having documents relating to or concerning Applicant to permit a duly appointed agent of the Indiana Gaming Commission to review and copy any such documents, whether or not such documents would otherwise be protected from disclosure by any constitutional, statutory or other legal privilege. 3. If the person or entity to whom this request is presented is a brokerage firm, bank, savings and loan, or other financial institution or any officer of same, Applicant hereby authorizes and requests that a duly appointed agent of the Indiana Gaming Commission be permitted to review and obtain copies of any and all documents, records or correspondence pertaining to Applicant, including but not limited to past loan information, notes cosigned by Applicant, checking account records, savings deposit records, safe deposit box records, passbook records, and general ledger folio sheets. 4. Applicant hereby makes, constitutes, and appoints any duly appointed agent of the Indiana Gaming Commission Applicant's true and lawful agent for Applicant in Applicant's name, place, stead, and on Applicant's behalf and for Applicant's use and benefit in the retrieval of information, whether or not such information is considered confidential, but only in connection with the lawful background investigation required to ascertain my suitability for a gaming license. I do hereby authorize said agent: (a) to request, review, copy, sign for, or otherwise act on behalf of the Applicant for investigative purposes with respect to documents and information in the possession of the person or entity to whom this request is presented as Applicant might; (b) to name the person or entity to whom this request is presented and insert that person's or entity's name in the appropriate location on this request; (c) to place the name of the Indiana Gaming Commission agent presenting this request in the appropriate location on this request. 5. Applicant grants to said agent full power and authority to request, review, copy, and perform all and every act and thing whatsoever requisite, proper, or necessary to be done, in the exercise of any of the rights and powers to gather information herein granted, as fully as to all intents and purposes as I might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that said agent, or his substitute or substitutes, shall lawfully do or cause to be done by virtue of this authorization and rights and powers herein granted.

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6. This power of attorney ends eighteen (18) months from the date of execution or at the termination of all licenses issued to Applicant by the Indiana Gaming Commission, whichever occurs later. 7. Applicant does, for itself, its heirs, executors, administrators, successors and assigns, hereby release, remise, and forever discharge the person or entity to whom this request is presented, and his or its agents and employees from any and all manner of actions, causes of action, suits, debts, judgments, executions, claims and demands whatsoever, known or unknown, in law or equity, which Applicant ever had, now has, may have, or claims to have against the person or entity to whom this request is presented or his or its agents or employees arising out of or by reason of complying with this request. 8. Applicant agrees to indemnify and hold harmless the person or entity to whom this request is presented and his or its agents and employees from and against all claims, damages, losses, and expenses, including reasonable attorneys' fees arising out of or by reason of complying with this request. 9. A reproduction of this request by photocopy shall be for all intents and purposes as valid as the original.

IN WITNESS WHEREOF, I have executed this request at ___________________________________, (City) ___________________________ on the ____________ day of ___________________, 20______. (State) ________________________________________ Applicant By: ____________________________________ Its: ____________________________________

STATE OF ________________________ SS: COUNTY OF ______________________ Before me, the undersigned, a Notary Public in and for said County and State, personally appeared ____________________________________ and acknowledged the execution of the foregoing instrument as his/her voluntary act and deed.

WITNESS, my hand and Notarial Seal, this _________________ day of _______________, 20___.

__________________________________________ Notary Public, Written Signature

__________________________________________ Notary Public, Printed Signature 19

My commission expires: _______________________ County of Residence: _________________________

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RELEASE OF ALL CLAIMS

The Applicant has filed with the Indiana Gaming Commission ("Commission") certain forms and documents in connection with a written request for licensing by the Commission ("Application"). In consideration of the assurance by the Commission that a determination of suitability of the Applicant will be made following the completion of a deliberate, intensive and thorough investigation of the Applicant, including but not limited to background, associates, and finances, the Applicant does for itself, its heirs, executors, administrators, successors and assigns, hereby release, remise, and forever discharge the State of Indiana, the Commission, its members, agents, and employees, from any and all manner of actions, causes of action, suits, debts, judgments, executions, claims and demands whatsoever, known or unknown, in law or equity, which the Applicant ever had, now has, may have, or claim to have against any or all of said entities or individuals arising out of or by reason of the processing or investigation of or other action relating to the Application. I, the duly authorized _______________________ of the Applicant, have read this affidavit and understand its terms. On behalf of and in accordance with the instructions of the Applicant, I execute it with full knowledge that the Applicant will be bound hereby. IN WITNESS WHEREOF, I have executed this request at ____________________________________, _________________________ on the _______________________ day of _____________________, 20_____.

__________________________________________ Applicant STATE OF _______________________ SS: COUNTY OF _____________________ By: ________________________________ Its: ________________________________

Before me, the undersigned, a Notary Public in and for said County and State, personally appeared __________________________________ and acknowledged the execution of the foregoing instrument as his/her voluntary act and deed. WITNESS, my hand and Notarial Seal, this ____________ day of __________________, 20___.

My commission expires ______________________ __________________________________________ Notary Public, Written Signature County of residence _________________________ __________________________________________ Notary Public, Printed Signature

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State of ______________________ SS: County of ____________________

I, _______________________________, being the duly authorized _____________________________ (Officer) (Office) of __________________________________, being first duly sworn upon oath or affirmation, depose and state: (Name of Applicant) that, except as reported in Applicant's Application ("Application"), Applicant has no agreements or understandings with any person or entity and no present intent to hold as agent, nominee or otherwise any interest in the Application; that, except as reported in the Application, Applicant has no agreements or understandings with any person or entity and no present intent to pay any sums of money or give anything of value as, including but without limitation, a finder's fee or commission to any person or entity related to the acquisition of any interest in the Application; that, except as reported in the Application, Applicant has no agreements or understandings and no present intent to pay any sums of money or give anything of value as, including, but without limitation, a finder's fee or commission to any person or entity related to the sale of any interest in the Application; that any funds used or to be used, and any liabilities incurred or to be incurred by Applicant in the acquisition of any interest in the Application were not provided to Applicant or made available to Applicant through the efforts of any person or entity not reported in the Application; that, except as reported in the Application, no person or entity has provided collateral for or guaranteed payment of any loans made to Applicant which relate to the Application.

I, the duly authorized ______________________ of the undersigned, have read this Affidavit of Full (Office) Disclosure and understand its terms. On behalf of and in accordance with the instructions of the undersigned, I execute it with full knowledge that the undersigned will be bound hereby.

__________________________________ Applicant

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By: ________________________________ Its: ________________________________ Address: ___________________________ ___________________________

STATE OF __________________________ SS: COUNTY OF ________________________ Before me, the undersigned, a Notary Public in and for said County and State, personally appeared _________________________________ and acknowledged the execution of the foregoing instrument as his/her voluntary act and deed. WITNESS, my hand and Notarial Seal, this ______________ day of ________________, 20___.

___________________________________ Notary Public, Written Signature

___________________________________ Notary Public, Printed Signature

My commission expires: ______________________ County of Residence: _________________________

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VERIFICATION

I, ___________________________________, being the duly authorized _________________________ (Officer) (Office) of _______________________________________, being first duly sworn upon oath or affirmation depose and (Name of Applicant) state: 1. 2. On behalf of Applicant I submit this Application. I swear (or affirm) and certify that the information contained in this application is true, complete and accurate to the best of my knowledge and belief.

______________________________ Applicant

STATE OF ________________________ SS: COUNTY OF ______________________

By: _______________________________ Its: _______________________________

Before me, the undersigned, a Notary Public in and for said County and State, personally appeared __________________________________ and acknowledged the execution of the foregoing instrument as his/her voluntary act and deed. WITNESS, my hand and Notarial Seal, this _____________ day of _______________________, 20___.

My commission expires ________________________

__________________________________________ Notary Public, Written Signature __________________________________________ Notary Public, Printed Signature

County of residence ___________________________

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