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, 322KB)* April 2017

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

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, 360KB)* April 2017

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