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The SFN 53859 form, commonly referred to as the Lottery Record/Credit Check form, is an essential document utilized by the Office of the Attorney General in North Dakota for individuals seeking to become lottery retailers. This form plays a critical role in ensuring that applicants meet the necessary qualifications by allowing for thorough background checks. It gathers vital information, including the applicant's personal details such as their name, Social Security number, and addresses, as well as their employment history. The form also requires disclosure of any previous names and a history of residence in other states over the past five years, which is crucial for conducting comprehensive record checks. Applicants must authorize the Attorney General’s office to investigate their criminal history and financial records, particularly if they are sole proprietors. A fee is associated with out-of-state record checks, emphasizing the importance of compliance with the requirements outlined. By signing the form, applicants affirm that the information provided is accurate and agree to the necessary investigations, thereby facilitating a transparent process aimed at maintaining the integrity of North Dakota's lottery system.

Similar forms

The SFN 53859 form is essential for those applying for a lottery retailer license in North Dakota. It collects vital information for conducting record and credit checks. Here are six other documents that share similarities with the SFN 53859 form:

  • Form W-2: This tax form reports wages paid to employees and the taxes withheld. Like the SFN 53859, it requires personal information and is used to verify financial status.
  • Form I-9: Used for employment eligibility verification, this form requires personal data and proof of identity. Both documents aim to confirm the legitimacy of individuals in their respective contexts.
  • Credit Application Form: This document collects information about a person's financial history to assess creditworthiness. Similar to the SFN 53859, it involves personal details and authorizations for checks.
  • Background Check Authorization Form: This form allows employers or organizations to conduct background checks on individuals. Both forms require consent and personal information to proceed with investigations.
  • State License Application: This document is necessary for various professional licenses and requires personal and financial information. Like the SFN 53859, it is used to evaluate eligibility based on background checks.
  • ADP Pay Stub Form: Essential for both employers and employees, this document provides a detailed record of earnings and deductions for a specific pay period, useful for personal financial management. More information can be found at smarttemplates.net.
  • Business License Application: When applying for a business license, individuals must provide personal and business information. This parallels the SFN 53859, as both require thorough checks to ensure compliance with regulations.

How to Use Sfn 53859 North Dakota

Filling out the SFN 53859 form is a straightforward process that requires accurate information about your personal and business details. Once completed, this form will accompany your Lottery Retailer License Application. Make sure to provide all necessary information to avoid delays in processing.

  1. Identify the type of applicant: Check the appropriate box for Sole Proprietor, Corporate Director/Officer, Partner, Shareholder, or General Manager.
  2. Fill in your business information: Enter your DBA (Doing Business As) name, business street address, and control number.
  3. Provide personal details: Input your full name, Social Security Number, date of birth, place of birth, and sex.
  4. Complete your addresses: List your current home address and, if applicable, your previous home address from the last two years.
  5. Other names: Indicate if you have used any other first or last names. If yes, provide all names.
  6. Employer information: If your employer differs from your DBA, include the name of your employer.
  7. Contact numbers: Provide your home and work telephone numbers.
  8. State residency: Answer whether you have lived in any state other than North Dakota in the last five years. If yes, list those states and the corresponding years.
  9. Authorization: Read the declaration statement, then sign and date the form to authorize the Office of Attorney General to conduct the necessary checks.
  10. Privacy Act Notification: Understand the implications of providing your Social Security Number and its necessity for processing.
  11. Payment: Indicate the amount remitted for the record check fee.

Dos and Don'ts

When filling out the SFN 53859 North Dakota form, consider the following guidelines:

  • Ensure all information is accurate and complete before submission.
  • Use clear and legible handwriting or type the information to avoid confusion.
  • Include your social security number, as it is necessary for the background check.
  • Review the form for any required signatures before sending it in.
  • Attach any additional documentation requested, especially if you have lived in other states.
  • Keep a copy of the completed form for your records.

Avoid these common mistakes:

  • Do not leave any sections blank; incomplete forms may be rejected.
  • Avoid using nicknames or aliases unless specifically instructed to do so.
  • Do not forget to check the appropriate box regarding previous names used.
  • Do not submit the form without verifying that all fees are paid.
  • Refrain from providing false information, as this can lead to serious consequences.
  • Do not ignore the privacy notice; understand how your information will be used.

Document Example

File Breakdown

Fact Name Details
Form Title Lottery Record/Credit Check
Form Number SFN 53859
Governing Law N.D.C.C. sections 53-12-13 and 53-12-14; N.D.A.C. section 10-16-02-03
Purpose This form is used to conduct a record and credit check for lottery retailer license applications.
Submission Requirement Must be submitted with the Lottery Retailer License Application.
Social Security Number Required for conducting criminal history record and credit checks.
Fee for Record Check North Dakota: $15. Fees may apply for out-of-state checks.
Signature Requirement The applicant must sign to authorize the investigation of their records.

Common mistakes

Filling out the SFN 53859 form in North Dakota can be a straightforward process, but many people make common mistakes that can delay their application. One frequent error is not providing all required personal information. Applicants often forget to include their full name, Social Security number, or current and previous addresses. This information is crucial for the Office of Attorney General to conduct background checks.

Another mistake is failing to check the box for whether they have used any other names. If a person has a maiden name or a nickname, they must list it. Omitting this detail can lead to complications in the application process. It’s important to be thorough and transparent when filling out this section.

Many applicants also overlook the section regarding residency in other states over the past five years. If someone has lived outside North Dakota, they need to list those states. Not doing so can result in delays, as the Office will need to request records from those states. This could incur additional fees, which applicants may not be prepared for.

Another common error involves the authorization section. Some people forget to sign and date the form. This step is essential, as it confirms that the information provided is accurate and allows the Office to conduct necessary checks. A missing signature can halt the application process.

People sometimes misinterpret the privacy notification regarding their Social Security number. They may think it’s optional, but providing it is crucial for processing the application. Without it, the Office may not be able to complete the required checks, potentially leading to a denial of the application.

Additionally, applicants often make mistakes in the payment section. They might not include the correct amount or forget to check the payment method. Ensuring that the payment is accurate and included with the application is vital to avoid processing delays.

Another mistake is not providing a valid phone number. Applicants should include both home and work numbers, as this allows the Office to reach them if there are questions or issues with their application. Missing contact information can lead to unnecessary delays.

Finally, applicants may fail to read the entire form carefully. Skimming through the instructions can lead to misunderstandings about what is required. Taking the time to read the form thoroughly can prevent many of these common mistakes and ensure a smoother application process.

FAQ

What is the purpose of the SFN 53859 form?

The SFN 53859 form is used for conducting a record and credit check as part of the application process for obtaining a lottery retailer license in North Dakota. It collects essential personal information, including the applicant's name, social security number, and residency history. The information gathered allows the Office of Attorney General to verify the applicant's eligibility to operate as a lottery retailer.

Who needs to complete the SFN 53859 form?

The form must be completed by individuals applying for a lottery retailer license in North Dakota. This includes sole proprietors, corporate directors, officers, partners, shareholders, and general managers who are primarily responsible for the financial affairs of the business. Each individual involved in the application process may need to provide their information on the form to facilitate a thorough background check.

What information is required on the SFN 53859 form?

The SFN 53859 form requires various pieces of information. Applicants must provide their name, social security number, date of birth, and current and previous addresses. Additionally, the form asks for any other names the applicant may have used, including maiden names or nicknames. It also requests details about the applicant's employment and residency over the past five years, which is crucial for conducting out-of-state record checks if applicable.

What happens if I do not provide my social security number on the SFN 53859 form?

Providing a social security number is voluntary; however, it is essential for the Office of Attorney General to conduct accurate criminal history and credit checks. If an applicant chooses not to provide this information, it may hinder the ability to perform these checks. Consequently, the Office may decline to process the lottery retailer license application, potentially preventing the applicant from becoming a licensed retailer.