Lg555 Form – Fill Out and Use This PDF

Updated: Nov 3, 2026

The Lg555 form is a crucial document for organizations in Minnesota engaged in lawful gambling, specifying government approval or acknowledgment for the use of gambling funds. It ensures that the expenditures contribute towards lawful purposes such as wildlife management, trail maintenance, safety training, and water quality testing, without any direct benefits to the organization itself. If you're involved in such activities and need to document the use of your funds properly, click the button below to start filling out your form.

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Lg555 Form PDF Details

In Minnesota, the oversight of lawful gambling activities is meticulously structured, ensuring that funds derived from gambling are utilized for approved purposes that benefit the community. The LG555 form, an integral piece of documentation within this framework, serves multiple critical functions. Primarily, it facilitates the reporting of the intended use of gambling funds by organizations, specifying categories such as contributions to government units, wildlife management, trail maintenance, safety and educational program supplies, and citizen-led water quality testing initiatives. This form, while not required to be submitted to regulatory bodies like the Gambling Control Board or Department of Revenue, plays a vital role in maintaining transparency and accountability within organizations. It requires detailed exposition of proposed expenditures and necessitates affirmations that no financial benefit will return to the gambling organization, ensuring that the funds serve the public interest. Moreover, the form bridges communication with governmental or environmental bodies for projects requiring specific approvals, like those involving the Minnesota Department of Natural Resources (DNR) or the Minnesota Pollution Control Agency (MPCA). By facilitating government acknowledgment of gambling fund use, the LG555 form upholds the integrity of charitable gambling operations in Minnesota, marking a critical checkpoint in the lawful administration of gambling proceeds.

Question	Answer
Form Name	Lg555 Form
Form Length	1 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	15 sec
Other names	LG555, lg555, nongovernmental, MPCA

How to Fill Out Form LG555

Form LG555 at a glance

What it is: Minnesota Lawful Gambling LG555 is the Government Approval or Acknowledgment for Use of Gambling Funds.

Who signs: The Chief Executive Officer signs, and the representative of the unit of government signs to acknowledge and approve the contribution amount.

A filled-in Form LG555 example: an organization donates to a city

Form LG555 example filled out, example: an organization donates to a city — An organization with a lawful gambling license donates to a city. Category A is ticked, so the other expenditure category boxes stay empty. The picture shows the form and all its values are invented. The donation to other unit of government is ticked, so the Wildlife, Trails, Safety training and Water quality testing boxes stay empty. The contribution amount is the whole proposed expenditure.

How to fill out Form LG555, box by box

Organization and expenditure information

Attach additional sheets if necessary.

Enter the Organization Name, the License Number, the Address and the City/State/Zip.

Amount and expenditure category

In 1, enter the Amount of proposed lawful purpose expenditure. In 2, check one expenditure category. A: Contribution to a unit of government-United States, state of Minnesota, or any of its subdivisions, agencies, or instrumentalities. B: Wildlife management project or activity that benefits the public at large, with approval by the Minnesota Department of Natural Resources (DNR). C: Grooming and maintaining snowmobile or all-terrain vehicle trails established under Minnesota Statutes, Sections 84.83 and 84.927, including purchase or lease of equipment, with approval by the DNR, and all trails must be open to public use. D: Supplies and materials for safety training and educational programs coordinated by the DNR, including the Enforcement Division. E: Citizen monitoring of surface water quality testing for public waters by individuals or nongovernmental organizations, with Minnesota Pollution Control Agency (MPCA) guidance on monitoring procedures, quality assurance protocols, and data management, providing that data is submitted to the MPCA.

Describe the proposed expenditure

In 3, describe the proposed expenditure, including vendors.

Chief Executive Officer's Signature

Sign, and enter the Date, the Print Name and the Daytime Phone.

Under NO FINANCIAL OR OTHER BENEFIT, the Chief Executive Officer affirms that the contribution or expenditure does not result in any monetary, economic, financial, or material benefit to the organization, in compliance with Minn. Rule 7861.0320, subp. 17, para. C.

Under FOR DNR-RELATED PROJECTS, the Chief Executive Officer affirms that when lawful gambling funds are used for grooming and maintaining snowmobile or all-terrain vehicle trails or for any wildlife management project for which reimbursement is received from a unit of government, the reimbursement funds must be deposited in the lawful gambling account and recorded on form LG100C.

Under FOR SURFACE WATER QUALITY TESTING, the Chief Executive Officer affirms that the MPCA has been consulted in developing the monitoring plan and that the data collected will be submitted to the MPCA.

For surface water quality testing, send the form for signature to: Manager, Water Monitoring Section, Minnesota Pollution Control Agency, 520 Lafayette Road North, St. Paul, MN 55155.

Government approval/acknowledgment

Enter the Contribution amount, and check one Government use of contribution.

Check one. Wildlife: DNR approves the wildlife management project or activity. Trails: DNR approves the grooming/maintaining of snowmobile and/or all-terrain vehicle trails. Safety training: DNR approves the supplies/materials for DNR safety training and educational programs. Water quality testing: MPCA approves the surface water quality testing project. Donation to other unit of government: city, county, state, federal, or any of their subdivisions, provided the funds will not be used for a pension or retirement fund.

Enter the Unit of Government, the Phone, the Address and the City/State/Zip.

By signature, the representative of the unit of government acknowledges and approves the contribution amount for the use as listed.

Sign, and enter the Date, the Print Name and the Title.

Common questions about Form LG555

Where do I file it?

Keep this completed form attached to the LG100C in your organization's records. You do not need to submit this form to the Gambling Control Board or the Department of Revenue.

Sources

[1] Form LG555, Government Approval or Acknowledgment for Use of Gambling Funds, Minnesota Gambling Control Board (the Official source link on this page).