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Request For Lottery

Complete the form below to express interest in being a Lottery Retailer. A Lottery Representative will contact you for further information.
Failure to provide contact information for all required applicants, will result in delay of processing and possible rejection of the application.

TYPE OF REQUEST:

RETAIL LOCATION INFORMATION:

All Owners, Members of an LLC, officers, directors, and shareholders of a corporation, must provide their name and email address

TYPE OF BUSINESS (Check one):

Submit

COMPLETE THIS FORM TO EXPRESS INTEREST IN BEING A LOTTERY RETAILER. A LOTTERY REPRESENTATIVE WILL CONTACT YOU FOR FURTHER INFORMATION. TO BECOME A LOTTERY RETAILER, APPLICANTS MUST SUCCESSFULLY COMPLETE THE LICENSING AND APPLICATION PROCESS IN KRS 154A AND 202 KAR 3:030.