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Oregon

3960398 Lxpires 09-07-2023


WALLEN,
WALLEN , LURISA
LURI SA LEA

DOB 09-07-1967 Issue Date .10-01


Endorsements Sex
F ~19
~
1983
Restrictions Height . J Weight
we
5’07”
5'07" 210
21

WALLEN, LURISA LEA


87816 SALTAIRE ST FLOR
PO BOX 1628
FLORENCE, OR 97439
97 439

J f,;.•.f'fflCA aoctr..L SFCUt'llfY AOMINI f'AAilON ONIT~O BTAftS OPAMf1.HICA SOCIAL MCURl'f"Y A0~,11Nl$fl\ATION ur,ITEO SfATIE.S 0" AMERICA SOClAL !>€Cvn,rv A ~ fRATIOU VNlflO !it AT( :, OF AM ~

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1C - WALLEN, LURISA LEA □ S 0 299607

’Aliases y Background Check Y Licenses Y Applications’


its T Letters Y Affiliations Y File Y Docs
Finger Prints ln House
Title Date ln
In House 7/2/2021
First Name Certificate Of Identity
LURISA No
Has Substantial Interest Yes No
No
(More detail available in the Affiliations tab)
Middle Name LEA

Last Name WALLEN


WALLEN Online Waiver (Mall Paper)

Suffix
Suffix Tribe
Tribe | - Please Select a Tribe -

Birth
of Birth
Date of 9/7/1967
License/ IO#
-------
Gender Female v

Email Address

Address Line
Address Line 1 16907 SE 354TH
354T H PL

Line 2
Address Line

Country United States


Stales v

State Washington

City AUBU RN
AUBURN

ZIP/Postal Code
ZlP/Postal 98092

County KING

Psuedo
Psuedo SSN Real SSN

Home Phone 1503) 847-0408

Work Phone
Work

Cell Phone
Edit
E Background
dit B Check
ackground C heck
Search

Da y JIS
Daily JlS Checks
Checks WALLEN
WALLEN,, LURISA LEA

Check Type
Background Check Type JudiciallnformationSystemCheck

Purpose Employment V

lfflil...]
Request Date

Request Number
Number
:===========:
6128/20 22
6/28/2022

1
Result
Result OK V

Result Received Date 6128/2022


6/28/2022 lfflH
SID
SID

Contact Licensing Staff


staff to View Report
Report

New Report Path Choose File No file chosen

Employer Number
Number TR-00005

Note

Last Check 06/28/2022


06/28/2022

1C WALLEN, LURISA
LURISA LEA iffll
trl )-
000 2 99607
299607

Bl4 · afJM·
Individual j Aliases J Spouse YTraining f Background Check T Licenses
' Employments Cases j Locks y Comments Letters
iftjifejtApplicatkms
Affiliations y File y Docs
!Mi#I

L icenses/Certifications/ Eligibility
Licenses/Certifications/Eligibility

ID Number Type Class Effective Date.. Expiration Date Status Date

.'.iU'l~
582398 69-47705
69-47705 Classl l 1Ga min _Emplc,ye,e
ClasslllGamingErrployee ,ocSpe,:i-ed
NotSpedfied 7// 1 , 22022
7 022 6 ' 330/
0 / 2202_3
023 Aa:r1
Activee , , / 2022
7/7/2022 0
£

564737
56ol 7]7 69·47705
69-47705 Cla;;sll l G:a mingE 11lc, e,e
CbsslllGamingErrployee otSpe · e d
I'totSpedfied 7/ 202
7/1,2021 6/30/ 2022
6'30/2022 Rerie·,·,ed
Renewed 7/7/ 2022
7/7/2022 0
Q

52]
523064 69•47705
69-47705 d a.ss 111Ga lll',lErnDIO
ClasslllGamingErrpIcvee * , ocSpecified
NotSpecF’ed 1-0/1 2019
10/11/2019 10/ 0/'2020
10/10, 2020 Lapse
Lapse 0/ 2 2020
10/25/2020 0
1C ril -). . 0[l] 0~0 I]
WALLEN, LURISA LEA Is 299601
299607 a
- .. ..
Individual
Employments T Cases Y fllltlllitllt&d· ·.
V Aliases f Spouse V Training T Background
Locks Y Comments T Letters Y
Check T Licenses
Affiliations Y Filo T
ippications
Docs

Applic.ationi;
Applications

1 IO i Received TuUlPaid/ App Cumplele/


Assigned To Vatfdaikm Application Type Employer
1 Nuinbei Date Lxpuauuci Requiied Final Status

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Gaining Erpbvee R.ec:-e:1t.'a l TJ!.-00005
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69•-inos
€9-47705 SL SIJ.,00
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12,-‘D7'2C21 NA
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00
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lt2,I07/2J2 1 305937
[12'07/2021 30593; 6539:JL "lKXl.£SHOOT Ir-Dl.o..N TUBE
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00
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69-477-0 5
€9-47735 !0/1~ 2019
10/10'2019 NA •eansttet
j s n: rut 2S7598
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5120,00
\leo:J Class
'Jew C12-ss ]H G:roi'lg Employee
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75Z323
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Statu5not
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5p?oal P..eOJEt Backorocnd di eek
00
O G
858658 Drop Scan

Val#
Vai#
305937
305937 12/07/2021
12/07/2021

WALLEN, LURISA L

9607 (69-47705)

AUBURN

1111111111 II 1111
299607
299607

3
©
©
1889

jeanettew
jeanettew 12/10/2021
12/10/2021
WASHINGTON STATE
WASHINGTON STATE GAMBLING
GAMBLING COMMISSION
COMMISSION
LOCATION:
LOCATION: 4565
4565 7th Avenue SE, Lacey
Lacey WA 98503
98503
MAILING ADDRESS:
MAILING P.O ..Box 42400,
ADDRESS: P.O. WA 98504-2400
42400, Olympia WA 98504-2400
TELEPHONE:
TELEPHONE: 360 86-3440 /I FAX
360-486-3440 FAX NUMBER:
NUMBER: 360-486-3631
360-486-3631
TOLL-FREE: 1-800-345-2529
TOLL-FREE: 1-800-345-2529 / TDD: 360-486-3637
TDD: 360-486-3637
WEB
WEB SITE:
SITE: www.wsgc.wa.gov
www.wsgc.wa.gov
CLASS III
CLASS TRANSFER / ADD
Ill TRANSFER EMPLOYER
ADD EMPLOYER
______***IMPORTANT READ BACK PAGE
* IMPORTANT READ PAGE**
* * ____________________________
(Mark (3
(Mark 1&1 appropriate
appropriate boxes.) TYPE
boxes.) ___________________T OF
YPE
O F APPLICATION
APPLICATION _____________________ FEE:
F $61.00
EE: $61.00
T ~
Transfer-
.
rans,er.
O Tribal Employer (69) to a Licensed Card Room (68)
Tribal Employer (69) to a Licensed Card Room (68)
~Tribal Employer (69) to Tribal
Tribal Employer (69) to Tribal
Employer (69)
. Employer (69)
O Licensed
Licensed Card Room (68) to Tribal
Tribal Employer
Employer (69) [ j C l alass Subcontractor Tribal
s s C / Subcontractor Tnbal Employee
Employee (69C)
(69C) to
Class
Class C /I Subcontractor
Subcontractor Tribal
Tribal Employee
Employee (69C)

1.
1. Name
Name ofof / \ /1 I .,,
Applicant:
Applicant: !~1 ~ ,1( ) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I
/ , _ , Last Name
LastName
iHVl.5L ________ . _________ _1 ~
FirstName
First Name · Ml Ml

Social Security Number: [L., 5JJ_1.~


Security Number: . J-L/-l-1-Li.!/_L?.2__J
Address:
Address: iiYr;o 7 SE m !J. ptze,,e,__ _____ _]
I,~ 1 1 _ _ _ _ _ _ _ _ _ _ _ _,
fkcbl.LJ'n W.P , , qt:2im 'Z:.._ _ ,
~
City s~ ~
I_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ IL ___~ - - ~ L _ _ _ I
County
County Telephone
Telephone
2. Current or
Current c' /} '
Previous
Previous Employer:
Employer: | L0bogu a.,.,. l m~ L-a5L~Q_ _________
Name
Name .
_I

13 1-SOD :se-!::d~d W/L-ul I ,f ~ 1-d~ H~&/23:j


3. New
New Employer:
Employer:
&1L!~ima1~ City

Name
/- - Teleph:__._ _ _.j

, lldurn_-+-w L ·___
· __, (f&;v ~ -· a
/ City
i z+iffzn
~
1 V7 -1-f2._fY:i._'f2.0/
phone
Telephone
i-kW W 4
/

4. First
FirstDayofWork:
Day of Work: | J$ ,,L'l~u OZ..L__, Expiration Date: L{t_,,, ?cz'__ _111.....&2 ~ I
Applicant License#: l.@_1.J-1 i/ '7 7 C-_
Since your last
5. Since last application,
application, have you been charged
charged with a crime,
crime, paid
paid a fine, been arrested, jailed, convicted, gone through
diversion
diversion orr placed
placed on
on probation?
probation?
O Yes pfoo o IfIf yes, please please attach
attach a statement
statement of explanation.
of explanation.
OATH
OATH OF
OF APPLICANT
APPLICANT
I declare
declare under
under penalty
penalty of
of perjury, under
under the laws ofof the state of of Washington,
Washington, that that all information
information provided
provided in this
this application
application is
true and complete
true complete to thethe best
best of
of my knowledge.
knowledge. I understand
understand that that untruthful,
untruthfu~. misleading,
misleading, or incomplete
incomplete answers
answers whether
through
through misrepresentation,
misrepresentation, concealment,
concealment, inadvertence,
inadvertence, or mistake,
mistake, are cause for for denial
denfal of
of an initial application or revocation of
of
any gambling
gambling licenses
licenses currently
currently held and will bebe disclosed
disclosed to my employer.
employer. I agreeagree to
to notify Washington State Gambling
notify the Washington Gambling
Commission
Commission should
should any information
information required
required on this
this application
application and I
and I or on my my Personal I
Personal I Criminal
Criminal History
History Statement
Statement change
become inaccurate
or become inaccurate in any way.
way. I understand
understand that
that ifif I fail to make
make such notification,
notification, itit may
may constitute
constitute grounds
grounds for
for denial,
suspension
suspension or or revocation
revocation of
of my
my license.
license. I further
further understand
understand that that ifif any
any criminal
criminal or civil actions
actions are filed against
against me (except
(except as
declared
declared in Section
Section 5 above),
above), I must
must inform
inform the
the Commission
Commission and my employer. employer. See WACs WACs 230-03-050, 230-03-055,
230-06-080, ?30-06-085. I will read the training
230-06-080, and 230-06-085. training document
document provided
provided by my my card room
room employer
employer within thirty days from
from my
first date of emplo ment and kee myself current of all rules and regulations.

Signature y. , j,
First. Middle. Last

Business Office
Business Office Use
Use Only:
Only:

Code: 21
Code: 211-1\..if\c__
1-|. Date: |l________|
J, Date: _ _ lJ/ /' |l ~_ _ __ 7 ,,
fI 102______________
1
______|, Amt$!_
Amt: $|
$|. Lo _!_,.oo
LC ' 1
|.00 Val#:
Vai #: T f 41 1\ T.T
1

GC4-192 (Rev.
GC4-192 (Rev. 10/1
10/11)
1 )""""" " “ Our
u Mission:
ission Protect
rotectlhthe Pubn
Public bby Ensuring
nsurin that
har Gambling
amblin is Lega
Legal and Honest
ndHone

OEC 0o77 2021


DEC 2021
ViSGC/LICi!.NsrN G
792313 Drop Scan

Val#
Vai #
297598 10/10/2 019
10/10/2019

WALLEN, LURISA L

1902 (69-47705)

AUBURN

Ill 111111111 II II Ill


299607

jeanettet 10/11/2019
I WASHINGTON
W A S H I N G T O N STATE GGAM BLING
A M1B COMMISSION
LING C OMMISSION
LOCATION: 4565 7th 7th Avenue
Avenue SE, Lacey WA 98503
MAILING ADDRESS: P.O. Box 42400, Olympia W WA
A 98504-2400
TELEPHONE: 360-486-3440 - FAX NUMBER: 360-486-3631
360-486-3631
TOLL-FREE: 1-800-345-2529 - TDD: 360-486-3637 E -D
WEB
W www.wsgc.wa .gov
E B SITE: www.wsqc.wa.gov
CLASS III INDIAN GAMING EMPLOYEE CERTIFICATION OCT 0O9~ 20I9
2019
** ** * ** CAUTION * ** * ** ., '
:.>
F e e s will
Fees will n ot b
not bee rrefunded
efunded a f t e r iissuance
after ssuance o
off a ttemporary
emporary c e r t i f i c a t i o n . _ 11
certification.
Failure to complete all information
information and requirements may cause delays or or denial ofof your application.
***SPECIAL INSTRUCTlo'NS * *
* SPECIAL INSTRUCTIONS / -7
♦• Please type
type or
or print
print all answers.
answers. Do Do not
not use pencil.
pencil. J I ' / C
♦• Submit
Submit a current
current photograph
photograph (no smallersmaller than 2" x 3", nor
nor larger
larger than 3" x 5")
5")-- ensure
ensure the photograph
photograph is a full facial
facial view. Write
Write
your
your name
name andand social
social security
security number
number on the back of the picture.
back of picture.
♦• All new
new applicant
applicant employees
employees are ai-e required
required to provide
provide proof
proof of identity.
identity. Please
Please provide of o~ ll\f~ f f l ~documents:
provide a copy of documents: a
valid driver's
driver's license,
license, a tribal
tribal identification
identification card, a state
state identification
identification card,
card, or
or a valid passport. Iflfybu~
you nave
ave any
aty questions,
questions, you may
may
contact your
contact your Customer
Customer Service
Service Specialist Individual's Unit
Specialist in the Individual’s Unit at 1-800-345-2529.
— APPLICANT INFORMATION~
APPLICANT INFORMATION oeT 16 !81!
OCT 10 2019-----------
1.
1. Last Name: II ;
LastName: /~:<2: L f :C.: 0: WSGC:/JJICENSING_J
i WSGC/LICENSINGi —I
L.J.A.J t: i :S: C{ :
First Name: 1 : : : : : I Ml: I L1
Maiden
Maiden I/ 1• } r. I .I . fl J_ 72 j" I
Alias Name: ~.J.......LJ-:e :0 : I : L,,:l'.1: f :--c:e..: f: f :0 :n:o:
ID:
Social Security#: I .~ Lj: ZJ-1-1.J-1.J-1 / :q :0 :2d B:rthdate: IC2 : C/ J/l--1'.LJ-2J/I /
H o m e Address: II / :Ul: 4 ·.LZ..: :2:
Home :.5: £: _J-3.JE: 'i:-rl? :P la c.?: : :
r Stree~x Number
i-11·//: /51...iJJ
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County:
County: | L.b',_f~:(J
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Telephone:
Telephone: Home: |I H I H Work: |I H 1-~
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Cell: L~ 0 :3 1-1$:l t/:
Cell: |3lZ9l3|-| y;'7l-l 0\ /\O\B\
71-112...!:/J D..fi1
2. Have you ever been issued a license
2. license/I permit
permit to work in
in a gambling
gambling activity? IF YES , complete the following
IF YES, following: :

City: 1__fil: o :v: :c:a: c :&


city: \ [ \ j \O 'V I I ! I ! I I I 1 I I I I I

County: I ikJQJ.fl
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Sl I I I I I I I I I ! I I I I I I I State : |I Q \
State: 0 :£
Date: From |1/
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7 I To I (2 :
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QUESTIONS TO DETERMINE LICENSE FEE REQUIRED


3. Answer
3. Answer thethe following
following question
question to determine
determine the fee of
of the
the Class III Certification you will
111 Certification will need.
need.
Over the
Over the past five (5) years,
years, have outside the state
have you lived outside state ofof Washington for total of six (6) or more months?
for a total months?
you are reinstating
(If you reapplying and you paid
reinstating or reapplying paid out-of-state
out-of-state fees with your original application,
your original application, and have not resided
resided out of
of
State since
Washington State since your
your original
original application,
application, mark
mark NO
NO and pay the the in-state
in-state fee.)
fee.)
-~es
£ Yes D NNoo Ill Employee
Class III -- In-State (No to question) $ 258.00
-- Out-of-State
Out-of-State (Yes to question) $ 320.00

EMPLOYMENT INFORMATION Tribal Numbi ’ TR-|.

A--- . - I .
44. N
Name of Tribal
a m e of Tribal Employer:
Employer:

N
Name of Subcontractor: I~~-~~-~~-~~-~~-~~-~~-~~-~~-~~-~~-~
a m e of I I I I I I I I I I I I I I I I I I I I I I

t- Position Title:
Title : TT:a I; k :Q. a ~ Dect1.-i-k-.r1
,__,:_____,_/_,._:--'-:-__._:__.:_.,_..,____,____,_---'-___,
! I I I I I ! ! I I I
D Pre-Certification
Pre-Certification - Tribal license issued,
issued , include
include the results and preliminary TGA determination.
D Class CC I/ Subcontractor (69C)
_____________________________ _ _______________________________________________________ ______
Business
B Office Use Only:
u s i n e s s Office Only:

ate: |I
J
Code: 211-|/(/?t
~ QpPate:
211-J..LQ_ | |J// 1I J| ! |_!_J _ _ _! ___I Amt: $l I-00
GC4-177-abr
GC4-1 (Rev. 4/14)
77-abr (Rev. 4/14) Our Mission:
Our Mission: Protect
Protect the Public
Public by
by Ensuring
Ensuring that
that Gambling
Gambling is Legal
Legal and
and Honest
Honest Page 11 of
Page of 2
4

CRIMINAL
HAVE YOU
YQU EVER
EYER (as a JUVENILE
11.. Forfeited
Forfeited bail
Been arrested
2. Been
JUVENILE or
bail or
or paid
or an ADULT):
paid a fine
arrested or charged
ADULT):
fine over
over $25?
charged with a crime?
crime?
5.Are
5. Are you subject to any warrants
failure to appear
failure appear charges?
warrants
charges?
□□ Yes
Yes
'
?c HISTORY ~
Been convicted
3. Been convicted or jailed? 6. Had aa gambling
gambling license
license denied
-~ o
STATEMENT Sc -
Been placed on probation
4. Been probation oror community
community service? revoked?
suspended or revoked?
You must answer "YES" ifif any of the above have occurred, even even ifif charges
charges were dismissed, deferred,
were dismissed, deferred, or
- changed. Explain
changed. each charge
Explain each charge fully below
below and attach
attach additional
additional sheets
sheets as needed. False False or incomplete
incomplete
information may
information may result
result in denial
denial / revocation
revocation// administrative
administrative closure of your application.
application . The following traffic
violations
violations may be excluded from your explanation: speeding, signal, signal, sign, seatbelt, and and right-of-way.
right-of-way.
Date
Date
Disposition and
and Date
Date
Charge
Charge City
City County
County State
State Disposition
Charged
Charged

~
' .,. __
■ all l""l""'A ,...,, i!'r-,...\.11,..,.,-
IVIILI 11-\" I ;:,c:" V lvC: : D Yes D(No / Dates Served: Fmm: IU . / Type
Type of
of Discharge:
Discharge:

qOATH
q--OATH OF APPLICANT
penalty of perjury,
I declare under penalty perjury, under
under the laws of the state of Washington
Washington,, that all the
the answers and statements
statements are true
true,,
correct and complete.
correct complete. I understand
understand that
that untruthful
untruthful or misleading answers areare cause for denial
denial of mmyy application and / or
revocation ofof any
any certification
certification granted. II agree to notify the Tribal I/ State Gaming
Gaming Agency ifif any
any information required on this
application and/I or my Personal
application and Personal/I Criminal
Criminal History Statement, changes
changes oror becomes inaccurate
inaccurate in
in anyway.
any way. II understand
understand that
that ifif I
notification, it may constitute
fail to make such notification, constitute grounds for denial,
denial , suspension or revocation of m myy temporary or permanent
state certification. I further
further understand that the State Gaming Agency (Washington State Gambling Commission) may revoke,
Gambling Commission)
suspend or deny a state certification for any reason(s) it deems to be in the public
public interest under
under the provisions
provisions of Chapter 9.46
of the Revised (C
of C dp of ,Washington
Washington.

Sign/tufe ~ ___________________ Date: | / 1 z2i/i Zi /?i


y TRIBAL AUTHORIZATION
I hereby authorize the applicant to submit this application as a Class III Indian Gaming Employee.

Last Name: mAUDl ; i

First Name: Ml:I__J

Signature of
Authorizing Tribal Agent: Date: | / |£ |/| 0 Z? } I |

3 WAIVER FOR TRIBAL MEMBERS ONLY


Under the terms of the
Under the Tribal State Compact - ifif you are a Tribal member of the the Tribe that you are applying
applying for, you are
required to sign the
required the waiver below.
I agree to submit to state certification to the
the extent
extent necessary to determine qualification
qualification to hold such certification, including
including all
hearings and
necessary administrative procedures, hearings and appeals
appeals pursuant
pursuant to RCW 9.46, WAC 230-17,
230-17, and
and the
the State
State Administrative
Administrative
Act, RCW 34.05.
Procedures Act, 34.05.. I further
further waive any immunity defense, or otherother objection that I might
might have in allowing
allowing the
the
Washington State Gambling Commission to exercise their authority pursuant to the
their authority the provisions of
of the T
Tribal Compact for
ribal State Compact for
Ill Gaming.
Class III

Signature of Tribal Member:


Signature Member: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Name of Tribe:|

YOUR APPLICATION AND THE PUBLIC RECORDS ACT


APPLICATION AND
the moment we receive your
From the your application,
application , it becomes a public
public document subject to the Public Records Act
the Public Act (RCW 42. 56)
42.56)
and other Washington laws. The Commission may disclose disclose to the public,
public, other
other state
state or
orfederal discuss a
federal agencies, or discuss att a public
public
meeting all information set forth
meeting this application and all supplemental information submitted.
forth in this submitted. The Commission responds to
public document requests through a PublicPublic Disclosure Request process, In the
process. in the event that the Commission receives a public
that the public
this application or the
disclosure request regarding this the license file writing , that
file established, you may request in writing, that the
the Commission
notify you of such request as provided in RCW 42.56.540.
notify

GC4-177-abr (Rev. 4/14)


GC4-177-abr 4/14) Our
Our Mission:
Mission: Protect
Protect the Public by Ensuring
Public by Ensuring that
that Gambling
Gambling is
is Legal
Legal and
and Honest
Honest Page2
Page of2
2 of 2
Oregon
3960398 Lxpires 09-07-2023
WALLEN,
WALLEN , LURISA
LURI SA LEA

DOB 09-07-1967 Issue Date .10-01


Endorsements Sex
F ~19
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1983
Restrictions Height . J Weight
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21

WALLEN, LURISA LEA


87816 SALTAIRE ST FLOR
PO BOX 1628
FLORENCE, OR 97439
97 439

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WSGC/LICEuSING
W~GC/LICE . . ~SING
111111 IIIII IIII II Ill IIIIII IIII IIII Ill
CLASS:
C L A S S : C - Any single vehicle with a GVWR of not more than 26,000 pounds with the
proper endorsements. Any emergency vehicle operated by a firefighter.

This card belongs to the Social Security Administration and you must
return it if
if we ask for it.
If you find
If find a card that isn’t
isn't yours, please return it to:
Social Security Administration
P.O. Box 33008, Baltimore, MD 21290-3008

For any other Social Security business/inionnation,


business/infomiation, contact your
your. local
Social Security
Security office. If you
office. If you write to the above address for
for any business
other than returning a found card you will not receive a response.

Social Security Administration


SSA-3000 (10-2007)
Form SSA-3000
F55 7098506
F 7098506
MUCKLESHOOT
MUCKLESHOOT GAMING COMMISSION
Applications Sent to the Washington State Gambling Commission
PO Box
PO Box 42400
42400
98504-2400
Olympia, WA 98504-2400
Federal Express
VIA: Federal Express
10.08.2019
Last Name First Name Amount Check Comments
BUN SOKSREYNIN $158.00 X RENEWAL
CHARUSARN RANEE $158.00 X RENEWAL
DO
DO NHU $158.00 X RENEWAL
FRANK DEREK $158.00
$158.00 X RENEWAL
HAK CHENDA
CHENOA $158.00 X RENEWAL
LWAI CIN
GIN $158.00 X RENEWAL
MARCELO JENNY
JENNY $158.00
$158.00 X RENEWAL
MORRISON DELLA $158.00 X RENEWAL
NHEM SARET $158.00
$158.00 X RENEWAL
PHAN ANH TUAN $158.00
$158.00 X RENEWAL
RENTERIA JAVIER $158.00
$158.00 X RENEWAL
TAYLOR SUSAN $158.00
$158.00 X RENEWAL

WALLEN LURISSA
WR/SSA $320.00
$320.00 X III
Ill A OUT
OUT OF
OF STATE

$2,216.00
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Column1 Type Subject Object Title Start End
315109 IndividualToPremises WALLEN, LURISA L TR-00005MUCKLESHOOT INDIAN TRIBE;AUBURN Class I I I Em12/15/2021
283581
309879
IndividualToPremises
IndividualToPremises
1C WALLEN, LURISA L
WALLEN, LURISA L
TR-00005MUCKLESHOOT INDIAN TRIBE;AUBURN
TR-00021SNOQUALMIE TRIBE;SNOQUALMIE
Class I I I Em10/10/2019 08/01/2020
Class I I I Em07/01/2021 12/13/2021
License No
69-47705
69-47705
69-47705
Column1 Last First Middle Suffix Category Start Date End Date
161937 BLAND LURISA LEA Also Known As 10/10/2019
161936 CARTER LURISA LEA Also Known As 10/10/2019
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STATE OF WASHINGTON
GAMBLING COMMISSION
“Protect the Public by Ensuring that Gambling is Legal and Honest”

October 11, 2019

Marena Cross
Muckleshoot Indian Tribe
Tribal Gaming Commission
2700 Auburn Way S
Auburn WA 98002

RE: State Certification of Gaming Employees

In accordance with the provisions of Section 5(K) of the Tribal-State Compact for Class
III Gaming between the Muckleshoot Indian Tribe and the state of Washington, the
following Class III Gaming employees are granted certification.

Name File Number Validation Date Expiration Date


WALLEN, LURISA L. 69-47705 10/11/2019 10/10/2020
WIGGS, NEIL E. 69-44057 10/11/2019 10/10/2020

Sincerely,

Jeanette Trac

Jeanette Trac
Licensing Specialist
Washington State Gambling Commission
Licensing Operations Division
(360) 486-3531
Jeanette.trac@wsgc.wa.gov

cc: file

P.O. Box 42400 Olympia, Washington 98504-2400  (360)486-3440  (800)345-2529  FAX (360) 486-3631
From: Anderson, Julie (GMB) <julie.anderson@wsgc.wa.gov>
Sent: Wednesday, August 11, 2021 8:17:33 AM
To: Anderson, Julie (GMB) <julie.anderson@wsgc.wa.gov>; Conway, Steve
<steve.conway@leg.wa.gov>; Conway, Steve (GMB) <steveconway@harbornet.com>;
Gilmour, Peter (GMB) <peter.gilmour@leg.wa.gov>; Haifley, Brian
<Brian.Haifley@leg.wa.gov>; Holy, Jeff <jeff.holy@leg.wa.gov>; Julia Patterson (GMB)
<jpatt3kids@gmail.com>; Kloba, Shelley <shelley.kloba@leg.wa.gov>; Lelli, Kimberlie
<kimberlie.lelli@leg.wa.gov>; Levy, Alicia (GMB) <alicia.levy@wsgc.wa.gov>;
Rasavage, William <Will.Rasavage@leg.wa.gov>; Reeves, Kristine (GMB)
<kristine.reeves@wsgc.wa.gov>; Sizemore, Bud (GMB) <budsize@gmail.com>;
Sizemore, Bud (GMB) <bud.sizemore@wsgc.wa.gov>; Vick, Brandon
<brandon.vick@leg.wa.gov>
CC: GMB DL CAT <CAT@wsgc.wa.gov>
Subject: Commission Meeting Materials for tomorrow
Attachments: August Commission Packet.pdf

***Please do not reply all to this email***

Good morning,

Attached is the commission packet for tomorrow’s meeting. Please let me know if you have any
questions.

The meeting will begin at 9:30 Click here to join the meeting.

Julie
Julie Anderson
Executive Assistant
Washington State Gambling Commission
PO Box 42400
Olympia, WA 98504-2400
(360) 486-3453 desk
(360) 280-3937 cell
julie.anderson@wsgc.wa.gov

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