Skip to form

Montgomery County, Maryland

Bingo License FAQ


Need help with this form:
Dept. of Health & Human Services
Licensure & Regulatory Services
Address: 2425 Reedie Drive
9th Floor
Wheaton, MD 20902
Phone: (240)777-3986


General Assistance:
Call 311, Get it Done!
Email L&R

SeamlessDocs

Montgomery County, MD

Bingo License


Please review the frequently asked questions about the Bingo License Form before completing the application: https://www.montgomerycountymd.gov/HHS/LandR/Bingo.html
To get the fastest response, complete and submit your application online, including required attachments. We continue to accept paper applications – if you need a paper application, you can print the next screen and submit it via mail or drop off in our dropbox at the lobby.

If you have already submitted your application and payment, please do not submit the same applications twice (eg. online and by mail). Resubmissions are acceptable after you have received a formal decision of "Declined".

If you have any further questions, please email us at: LicensureAndRegulatory@montgomerycountymd.gov

Alternative format requests for people with disabilities. If you need assistance accessing this report you may submit alternative format requests by webform to the ADA Compliance Manager. The ADA Compliance Manager can also be reached at 240-777-6197 or at adacompliance@montgomerycountymd.gov.
Please check that you agree before continuing.
By continuing I agree that I am willing to complete a digital version of the document(s) and that information about my user session will be stored.
Signature HereClick to Sign
Your Name HereClick to Sign
Signature HereSigner2- Organization Officer Responsible Will Sign Here
Signature HereSigner3 - Organization Officer Responsible Will Sign Here
Signature HereSigner4- Notary Will Sign Here

Create Your Signature

Please fill in your name and email and then either draw or type your signature below.

x

Signature Type

Type Draw Upload Custom
Clear Signature

Signature will be applied to the page. You will have a chance to review after signing.

Check this box to continue

x

Additional Signatures Required

A complete statement of purpose and objectives of the qualified organization and the purposes for which the qualified organization will use the proceeds from the bingo, signed by the applicant(s). Click Here to Upload
Names and Address of all Organization Officers and Directors Click Here to Upload
A copy of the letter your organization received from the Internal Revenue Service establishing your group as a non-profit organization exempt from federal income tax under 26 U.S.C. § 501 (c)(3), (4), (7), or (10). Click Here to Upload