West Virginia Code § 47-21A-18

Information required in application for an Annual Platform Provider
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License.
An application for an Annual Platform Provider license shall include the following
information:
(a) The name of the applicant, the legal name of the entity, the jurisdiction and locale of
incorporation, telephone number, e-mail address, and the physical and mailing address of its
principal place of business;
(b) A description of methods by which they manage, administer, uor oversee a website
software system, web application, method, or other process for the purposes of collecting
moneys related to the sale of online raffles, securing and safekeeping all moneys collected
related to the sale of online raffle tickets, disbursing moneys collected from the sale of
online raffle tickets to the licensee before or after the online raffle or online raffle occasion,
and conducting licensed online raffles over the Internet;
(c) Provide statements that detail the costs ansd fee structures for any services that are
provided by the platform provider.
(d) State whether the applicant has ever had a previous application for any license relating
to the regulation of an online raffle refused, or whether any previous license relating to the
regulation of an online raffle has been revoked or suspended;
(e) Provide statements to the effect that the individuals and entities specified in subdivision
(a) of this section understand:
(1) That it is a violati on of this article to allow any persons other than those authorized by
this article to Vconduct business related to being a platform provider;
(2) That it is required to file the reports and keep the records as provided by this article; and
(3) That it is a crime to violate the provisions of this article and, that a violation of such
provisions may result in suspension or revocation of the platform provider license and denial
of applications for subsequent platform provider licenses;
(f) Provide a sworn statement by an authorized representative of the applicant that the
information contained in the application is true to the best of his or her knowledge;
(g) A list of the names and addresses of all officers and members of the board of directors, if
any, of the platform provider; and
(h) Any other necessary and reasonable information required by the commissioner.

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