The Montana 34 form is a registration document required by machine owners to register their approved accounting and reporting systems with the Montana Department of Justice, Gambling Control Division. This form enables owners to report machine data accurately and efficiently. Upon submission, the Division will provide a PIN and instructions for accessing the reporting system.
The Montana 34 form serves as a crucial tool for machine owners in the state, facilitating the registration of their approved accounting and reporting systems. This form is required by the Montana Department of Justice, Gambling Control Division, to ensure compliance with state regulations regarding gambling machine operations. Owners must complete the form to register their machines and report operational data accurately. The form collects essential information, including the licensee's name, contact details, and federal tax identification number. Furthermore, it requires specifics about the machines, such as meter readings, which must be reported electronically at designated intervals. Owners can choose a reporting frequency of either weekly or biweekly and must indicate their preferred day for submitting meter data. Upon approval of the form, the Division provides a personal identification number (PIN) along with instructions for accessing the reporting system. This structured approach not only promotes accountability among machine operators but also streamlines the regulatory process for the state, ensuring that all gambling activities are monitored effectively.
VGM REPORTING SYSTEM
OWNER/OPERATOR REGISTRATION FORM
Montana Department of Justice, Gambling Control Division
2550 Prospect Ave. ● PO Box 201424 ● Helena, MT 59620-1424
Phone: (406) 444-1971 ● Fax: (406) 444-9157
Type or print legibly using blue ink.
Machine owners must file a registration form to register the approved accounting and reporting system for the machines they own and use that system to report machine data to the Division. Once the Division receives the form, it will send the applicant a notice with a PIN and instructions on how to use the system.
MACHINE OWNER INFORMATION:
LICENSEE NAME
PHONE NUMBER
ADDRESS
FEDERAL TAX ID NUMBER
CITY, STATE, ZIP CODE
NAME OF CONTACT FOR NOTIFICATIONS
(Can be an accountant, route operator or bookkeeper, etc.)
ACCOUNT NUMBER (000000-XXX-GOA)
E-MAIL ADDRESS OF CONTACT
(Additional e-mail addresses should be provided on a
separate sheet of paper)
MACHINE INFORMATION: Upon submission and approval of this form, meter readings from all of the machines owned by the applicant and in operation at this location must be reported electronically at the time intervals and using the approved accounting system selected below.
Accounting System Information:
Please indicate the reporting frequency – weekly or biweekly – and the day of the week meter data will be reported:
Check one: □ Weekly □ Biweekly
Check one: □ Mon □ Tues □ Wed □ Thurs □ Fri
Check the box that best explains the accounting system you will be using:
□ Approved System
Name of System:
□ Web Entry
PRINTED NAME:
SIGNATURE:DATE:
Form 34 REV 10/07
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