The Department of Internal Affairs

Te Tari Taiwhenua | Department of Internal Affairs

Building a safe, prosperous and respected nation



 

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

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

*You need Adobe Reader installed on your computer to view these forms. If you are unable to open the forms we recommend you get the latest version of Adobe Reader. You can download and install Acrobat Reader for free from the Adobe website.