Retailer Application

APPLICATION REQUIREMENTS


No Lottery contract will be granted to an applicant who:

  • Has been convicted of a felony; misdemeanor involving gambling or theft;
  • Has not been in compliance with Nebraska tax laws;
  • Is granted a liquor license for the sale of alcoholic beverages for consumption on the premises unless such establishment holds a Class C liquor license with a sampling designation.
  • Is an employee of the Lottery or a spouse, child, brother, sister or parent of a Lottery employee who resides in the Lottery employee’s household
  • Has had a license or contract revoked by another lottery jurisdiction.
For complete eligibility and contractual requirements see Regulation Chapter 400 Lottery Game Retailer, Click Here.


EASY ONLINE APPLICATION SUBMIT ELECTRONICALLY!


Application forms are also available to download here in Adobe PDF Format.


Part 1:   Application Form - Main

Part 1A: Attestation Form - (Only Sole Proprietorships need to complete.)

Part 2:   Application Form - Background Information

Part 3:   Application Form - Financial Information

Part 4:   Application Form - W-9 Taxpayer Identification


Completed applications can be submitted via FAX to 402-471-6108; or mailed to Nebraska Lottery, PO Box 98901, Lincoln, NE 68509-8901.


For more information on becoming a Nebraska Lottery retailer, call the Nebraska Lottery offices in Lincoln at 800-587-5200 or 402-471-6100 (M-F, 8 a.m. to 5 p.m.), or email your request to lottery@nelottery.com.
Published on 08/05/2013