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Compliance Investigations and Audits Electronic Monitoring System (EMS) Fact Sheets (Gambling Act 2003) Gambling in Pubs and Clubs (Class 4) Info for Territorial Authorities |
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Forms
Click on the links below to open, print out or download .pdf* versions of the following gambling licence application and information forms.
View the Register of All Forms Related to Class 3 & 4 Gambling .pdf (9k)* If you require hard copies of any of these forms please contact the Gambling Compliance Group. Class 3 Gambling OnlyClass 3 Operator's (New) Licence .pdf (315k)* GC11 Application for a new licence to conduct Class 3 gambling. Class 3 Operator's (Amend) Licence .pdf (227k)* GC12 Application to amend a licence to conduct Class 3 gambling. Class 3 Housie Operator's (Renew) Licence .pdf (242k)* GC14 Application to renew a licence to conduct Class 3 gambling (Housie only). Class 3 & 4 Personal Information Form .pdf (284k)* GC5 Personal information form for operators of Class 3 and Class 4 gambling. Class 3 Audit and Prize Statement (Excluding Housie) .pdf (282k)* GC13 Audit and prize statement to be completed after a Class 3 gambling activity has been drawn / determined. Calcutta Calculation Spreadsheet .pdf (29k)* This form covers the calcutta operation in its entirety rather than just the auction, which is only one aspect of this gambling activity. It replaces the 'Calcutta Auction Record Sheet'. This sheet is to be attached to the 'Class 3 Audit and Prize Statement' form above. Licensed Promoter's Forms GC8 / GC10 / GC9 Licence application, licensed promoter's key person information, and licensed promoter and society agreement forms. Class 4 Gambling OnlyNew Class 4 Operator's Licence .pdf (310k)* GC1Use this form if you are a club 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 must also complete this application for each of the venues you want licensed. Use this form if you already have a Class 4 operator's licence and want to add a key person; remove a key person; change the designation of an existing key person.
If adding or changing the designation of a key person, that person must also complete this form. Use this form if you already have a Class 4 operator's licence and want to change your authorised purpose(s); problem gambling policies; method, system or policies for distribution of net proceeds; 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. New Class 4 Venue Licence .pdf (306k)* GC3 Use this form if you are a club or other corporate society wanting to add another venue to your Class 4 gambling licences. Class 4 Venue Costs Schedule .xls(28k)** Use this form for assessing Class 4 venue costs. This schedule forms part of any Class 4 venue agreement. The Schedule is in Excel format with formulas added and can be downloaded and used directly. Alternatively, it can printed out and completed manually. More information about venue expenses. Amend / Notify Key Person changes on a Class 4 Venue Licence .pdf (259k)* GC4 Use this form if you already have a Class 4 venue licence and want to add a key person (venue manager, venue operator or director or shareholder of a venue operator company); remove a key person; change the designation of an existing key person.
If adding or changing the designation of a key person, that person must also complete this form. Use this form if you already have a Class 4 venue licence and want to change the primary activity of the business at the venue; remove any gambling equipment from the venue (no fee); add any gambling equipment to the venue; change any gambling equipment at the venue; increase the number of gaming machines that may be operated at the venue; define the gambling area at the venue; change any condition of the venue licence; apply for an extension on the time Class 4 gambling has not been conducted at the venue; surrender the venue licence (no fee); dispose of gaming machines in the club’s or society’s storage (no fee). Renew Class 4 Gambling Licence (Gaming Machine Account Summary) - Multi venue clubs and other societies .pdf (292k)* GC6 This form is to be used by multi venue clubs and societies to renew their Class 4 gambling licences. Renew Class 4 Gambling Licence (Gaming Machine Account Summary) - Club renewals only .pdf (320k)* GC7 This form is to be used by single venue clubs to renew their Class 4 gambling licences. Clubs Self-Assessment Review .pdf (120k)* Licensed operators are required to comply with their statutory and regulatory obligations. This Self-Assessment Review tool has been designed to give clubs and the Department assurance that obligations are being complied with. Non-Club Societies Self Assessment Review .pdf (130k)* Licensed operators (i.e. societies and venues) are required to comply with their statutory and regulatory obligations. This Self-Assessment Review tool has been designed to give societies and the Department assurance that obligations are being complied with. Harm Prevention and Minimisation Guidelines .pdf (70k)* These guidelines will assist societies in self-checking levels of compliance against the Gambling Act 2003 and regulations relating to Harm Prevention and Minimisation.
Audited Financial Statements (for Class 4 Gambling)The Gambling Act 2003 requires Class 4 societies to provide audited financial statements to the Department of Internal Affairs within three months of the end of a society's financial year. The following templates will help clubs and corporate societies (Class 4 operators) to prepare their financial statements and their forecast financial statements which are necessary to complete the Application to Renew Class 4 Operator's License and Venue Licence(s).Templates for corporate societies Standard accounts - public societies .pdf (236k)* Forecast standard accounts - public societies .pdf (134k)* Forecast sign off - public societies .pdf (99k)* Templates for clubs Standard accounts - clubs .pdf (261k)* Forecast standard accounts - clubs .pdf (146k)* Forecast sign off - clubs .pdf (99k)* Note: These templates do not remove the need for judgement and consultation with your advisers when preparing your financial statements. Standard FormsThe Secretary for Internal Affairs has issued standard forms relating to Class 4 game rules and their use is mandatory. This means that corporate societies, venues or service providers cannot create and use their own versions, except where electronic copies can be generated in the same format as the standard forms and contain exactly the same information.
Casino Gambling OnlyPersonal Information Application: Associated Person .pdf (239k)* Application to be approved as an Associated Person (person who will have a significant influence) in a casino. Do not use this form for Class 3 or Class 4 gambling. More information about associated persons. Company Information Application: Associated Person .pdf (270k)* This form is used if your company is applying for Associated Person status in a casino. More information about associated persons. Certificate of Approval Application .pdf (381k)* Do not complete this application unless you have already been offered employment with a casino. More information about certificates of approval. Group Commission Organiser / Representative Application .pdf (96k)* This form is for those who wish to organise Group Commission Programmes in a New Zealand casino. Group Commission Organiser / Representative Renewal of Approval Application .pdf (54k)* This form is for those who wish to renew their approval to organise Group Commission Programmes in a New Zealand casino. Note: The Personal Information, Certificate of Approval and Group Commission Organiser / Representative application forms are subject to the Criminal Records (Clean Slate) Act 2004 (available on www.justice.govt.nz). If further information is required then legal advice is recommended.
*These documents are in Adobe Acrobat (.pdf) format. You need to have the Adobe Acrobat Reader installed on your computer. You can download a free version from the Adobe site. |
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Last updated: 16/07/2010 |
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