Transfer/Promotion Clearance Form

If applying for Transfer/Promotion please select and option below and fill out the top section of this form. If applying for a License Request Update, please select an option below and fill out the lower section of this form.

Form Usage:

Proposed Transfer/Promotion From

Proposed Transfer/Promotion To

License Request Update

License Information

Please note when issuing security clearance that access levels are not to be taken lightly or issued frivolously.

Reason for Update/Request

All changes will be 1/2 cost of initial license fee unless otherwise noted.


(Due to background check)

Gaming Commission Administrator