Minor Children Revenue Distribution
Application for withdrawal of 50% funds

Parent or Legal Guardian*
Full legal name
Minor Child Name*
Full legal name
Please enter a number less than or equal to 18.
Date of Birth*
Select Quarter
Only 50% of funds may be requested.

According to the Gaming Revenue Act adopted by the Tonkawa Tribal Committee Resolution No. T-R-12-08 all children's funds MUST be spent on health, safety, education, and welfare needs of each child. Receipts are required by law for accountability and MUST be provided to this office within 30 days of receipt of funds. Parents/Guardians are only allowed to withdraw 2 per caps - the coming per cap and one previous. Failure to comply will cause DENIAL of any future withdrawals.

I, the undersigned parent or legal guardian of the above named children, understand full the terms of this application and accept all responsibility for failure to comply.

Date*
This field is for validation purposes and should be left unchanged.