Form CGCC-2 "Application for Registration as a Financial Source" - California

What Is Form CGCC-2?

This is a legal form that was released by the California Gambling Control Commission - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2002;
  • The latest edition provided by the California Gambling Control Commission;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CGCC-2 by clicking the link below or browse more documents and templates provided by the California Gambling Control Commission.

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Download Form CGCC-2 "Application for Registration as a Financial Source" - California

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S
O
C
TATE
F
ALIFORNIA
C
G
C
C
(04/02)
ALIFORNIA
AMBLING
ONTROL
OMMISSION
A
R
F
S
PPLICATION FOR
EGISTRATION AS A
INANCIAL
OURCE
The applicant described below hereby applies to the California Gambling Control Commission (Commission) for
registration as a Financial Source under Regulation CGCC-2 of the Commission.
Part I - Applicant Information
Applicant Name:
Date of Application
Applicant's Form of Incorporation or Organization
Applicant's Place of Incorporation or Organization
Applicant's Principal Place of Business Address (street, city, state, ZIP)
Authorized Contact Person
Title
Telephone Number (
)
Name of the Tribe to which financing being provided
Part II - Eligibility Requirements
♦ Attached as Exhibit A to this application is the application for licensing submitted by the Applicant to the Tribal
Gaming Agency of the Tribe named in Part I pursuant to Section 6.4.6 of the Tribal-State Gaming Compact
between such Tribe and the State of California
♦ Attached as Exhibit B to this application
♦ Evidence that the applicant (including all wholly-owned subsidiaries), acting for its own account or the
accounts of other entities specified in clause (b) below, owns in the aggregate at least $100,000,000 of
securities of issuers that are not affiliated with the applicant; and
♦ Evidence that the applicant is on of the following types of entities (as indicated by applicant):
A federal-regulated or state-regulated bank or savings association or other federal- or state-regulated
lending institution;
A company that is organized as an insurance company, the primary and predominant business activity
of which is the writing of insurance of the reinsuring of risks underwritten by insurance companies, and
that is subject to supervision by the Insurance Commissioner of California, or a similar official or
agency of another state;
An investment company registered under the federal Investment Company Act of 1940 (15 U.S.C.
Section 80a-1 et seq.);
A retirement plan established and maintained by the United States of America, an agency or
instrumentality thereof, or by a state, its political subdivisions, or any agency or instrumentality of a
state or its political subdivisions, for the benefit of its employees;
An employee benefit plan within the meaning of Title I of the federal Employee Retirement Income
Security Act of 1974 (29 U.S.C. Section 1001 et seq.);
A securities dealer registered pursuant to the federal Security Exchange Act of 1934 (15 U.S.C.
Section 78a et seq.); or
An entity, all of the equity owners of which individually meet the criteria of this clause (b).
Part III - Representation and Agreement Regarding Eligibility
The undersigned hereby represents on behalf of the applicant that the applicant is eligible to register as a
Financial Source under Regulation CGCC-2. In addition, the undersigned hereby agrees on behalf of the
applicant to notify the Tribal Gaming Agency of the Tribe named in Part I of this application and the California
Gambling Control Commission promptly in writing of any termination of the applicant's eligibility for registration
under Regulation CGCC-2.
The undersigned hereby declares that s/he is an authorized officer or designee of the applicant with full authority to execute and
submit on behalf of the applicant to be registered as a Financial Source within the meaning of Regulation CGCC-2.
Signature
Title
Name of individual (please type or print)
Name of Company (please type or print)
S
O
C
TATE
F
ALIFORNIA
C
G
C
C
(04/02)
ALIFORNIA
AMBLING
ONTROL
OMMISSION
A
R
F
S
PPLICATION FOR
EGISTRATION AS A
INANCIAL
OURCE
The applicant described below hereby applies to the California Gambling Control Commission (Commission) for
registration as a Financial Source under Regulation CGCC-2 of the Commission.
Part I - Applicant Information
Applicant Name:
Date of Application
Applicant's Form of Incorporation or Organization
Applicant's Place of Incorporation or Organization
Applicant's Principal Place of Business Address (street, city, state, ZIP)
Authorized Contact Person
Title
Telephone Number (
)
Name of the Tribe to which financing being provided
Part II - Eligibility Requirements
♦ Attached as Exhibit A to this application is the application for licensing submitted by the Applicant to the Tribal
Gaming Agency of the Tribe named in Part I pursuant to Section 6.4.6 of the Tribal-State Gaming Compact
between such Tribe and the State of California
♦ Attached as Exhibit B to this application
♦ Evidence that the applicant (including all wholly-owned subsidiaries), acting for its own account or the
accounts of other entities specified in clause (b) below, owns in the aggregate at least $100,000,000 of
securities of issuers that are not affiliated with the applicant; and
♦ Evidence that the applicant is on of the following types of entities (as indicated by applicant):
A federal-regulated or state-regulated bank or savings association or other federal- or state-regulated
lending institution;
A company that is organized as an insurance company, the primary and predominant business activity
of which is the writing of insurance of the reinsuring of risks underwritten by insurance companies, and
that is subject to supervision by the Insurance Commissioner of California, or a similar official or
agency of another state;
An investment company registered under the federal Investment Company Act of 1940 (15 U.S.C.
Section 80a-1 et seq.);
A retirement plan established and maintained by the United States of America, an agency or
instrumentality thereof, or by a state, its political subdivisions, or any agency or instrumentality of a
state or its political subdivisions, for the benefit of its employees;
An employee benefit plan within the meaning of Title I of the federal Employee Retirement Income
Security Act of 1974 (29 U.S.C. Section 1001 et seq.);
A securities dealer registered pursuant to the federal Security Exchange Act of 1934 (15 U.S.C.
Section 78a et seq.); or
An entity, all of the equity owners of which individually meet the criteria of this clause (b).
Part III - Representation and Agreement Regarding Eligibility
The undersigned hereby represents on behalf of the applicant that the applicant is eligible to register as a
Financial Source under Regulation CGCC-2. In addition, the undersigned hereby agrees on behalf of the
applicant to notify the Tribal Gaming Agency of the Tribe named in Part I of this application and the California
Gambling Control Commission promptly in writing of any termination of the applicant's eligibility for registration
under Regulation CGCC-2.
The undersigned hereby declares that s/he is an authorized officer or designee of the applicant with full authority to execute and
submit on behalf of the applicant to be registered as a Financial Source within the meaning of Regulation CGCC-2.
Signature
Title
Name of individual (please type or print)
Name of Company (please type or print)