1) Qualified associations may use this form to apply for a license to conduct the game of bingo,
pursuant to the Bingo Law, 10 P.S. §§ 301—308.1.
2) All information shall be typed or printed in black or blue ink.
3) Submit the completed application to the county treasurer, or in any home rule county or
city of the First Class, where there is no elected treasurer, to the designee of the governing
authority. (For Philadelphia County, this is the City of Philadelphia Department of Licenses
4) Community recognized nonprofit organizations applying for a special permit to conduct
bingo for entertainment purposes only are exempt from paying any fee; the application and
special permit are issued free of charge.
5) Associations which conduct bingo during one period each year for not more than three (3)
consecutive days shall pay a $15.00 annual licensing fee.
6) Recognized senior citizens’ groups who conduct bingo for their members only shall pay a
fee of $50.00 per year.
7) The fee for all other nonprofit associations, including agricultural associations and county
fairs, is $100.00 per year.
8) The application shall be signed by the executive officer or secretary of the association. The
application does not require notarization.
9) If completing licensure by mail, please mail application and check to:
Adams County Treasurer
117 Baltimore St., Room 101
Gettysburg, PA 17325