Services › Casino and Non-Casino Gaming › Class 4 Operator's Licence Forms

• Application for a New Class 4 Operator's Licence (Category A)
• Application for a New Class 4 Operator's Licence (Category B)
• Class 4 Operator's Licence Key Person Amendments/Notifications
• Class 4 Operator's Licence Non-Key Person Amendments/Notifications
• Class 3 and 4 Key Person Applicants Personal Information

Application for a New Class 4 Operator's Licence (Category A)

Use this form if you are a club wanting to operate gaming machines at a single venue that the club owns or leases and you do not currently hold Class 4 Gambling Licences.

You also need to complete the 'Application for a New Class 4 Venue Licence' form for the venue you want licensed, and provide a 'Class 3 & 4 Key Person Personal Information' form completed by each key person in respect of the club and its venue. More information about Class 4 Licensing Criteria.

Form code	Form to use
GC1A	Application for a New Class 4 Operator's Licence - Category A (PDF, 442KB)* April 2017 See also: Guidance Notes (PDF, 349KB)* Updated May 2013

Application for a New Class 4 Operator's Licence (Category B)

Use this form if you are:

• a club wanting to operate gaming machines at more than one venue, or
• other corporate society wanting to operate gaming machines at a club or public venue

and you do not currently hold Class 4 Gambling Licences.

You also need to complete the 'Application for a New Class 4 Venue Licence' form for each of the venues you want licensed, and provide a 'Class 3 & 4 Key Person Personal Information' form completed by each key person in respect of the club/corporate society and/or venue(s). More information about Class 4 Licensing Criteria.

Form code	Form to use
GC1B	Application for a New Class 4 Operator's Licence - Category B (PDF, 410KB)* April 2017 See also: Guidance Notes (PDF, 177KB)* Updated October 2016

Class 4 Operator's Licence Key Person Amendments / Notifications

Amendment to Licence, or notification under section 54 of the Gambling Act 2003, related to Key Persons.

Use this form if you want to:

• add a key person;
• remove a key person;
• change the designation of an existing key person;
• notify changes in circumstances as specified in section 54 of the Act.

If adding or changing the designation of a key person, that person must complete the 'Class 3 & 4 Key Person Personal Information' form.

Form code	Form to use
GC2	Class 4 Operator's Licence Key Person Amendments/Notifications (PDF, 487KB)* April 2022

We’re making changes to some of the requirements relating to GC5, GC4 and GC2 forms to capture any potential conflicts of interest which may lead to fraudulent behaviour. Please make sure you are using the most up to date form to avoid delays processing your applications.

Class 4 Operator's Licence Non-Key Person Amendments / Notifications

Amendment to Licence, or notification under section 54 of the Gambling Act 2003, not related to Key Persons.

Use this form if you want to:

• change your authorised purpose(s);
• change your problem gambling policies;
• change your method, system or policies for distribution of net proceeds;
• change your governing document;
• apply to accumulate funds;
• make any other change that may affect your ability to comply with the Act or your Class 4 Operator's Licence;
• provide details of disposal of gaming machines from society storage (no fee).

Form code	Form to use
GC2A	Class 4 Operator's Licence Non-Key Person Amendments/Notifications (PDF, 333KB)* April 2017

Class 3 and 4 Key Person Applicants Personal Information

Personal Information Form for Class 3 and Class 4 gambling.

Form code	Form to use
GC5	Class 3 and 4 Key Person Applicants Personal Information (PDF, 2MB)* July 2022

A certified copy of photo identification is now required on all GC5 forms, if you possess none of the four forms of ID indicated on the form please provide an alternative certified identity document. The Department can assist you with supplying an appropriate ID.

If you need to know who can certify a document confirming it's a true copy of the original document, please visit www.justice.govt.nz.

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