Questionnaire Respecting Applicants for Lottery LicenceQuestionnaire Respecting Applicants for Lottery Licence
Determination of Eligibility
The Licensing authority will review all relevant documentation submitted to determine
eligibility for lottery licences. These decisions are based on what is considered
charitable in law, including the Criminal Code of Canada, previous court decisions,
Order-in-Council 2688/93 as amended, and the policies issued by the Registrar of
Alcohol and Gaming.
1.Registered Name of Organization (as shown on Governing Documents):
___________________________________________________________________
Operating Name, if different: ____________________________________________
Business Address: ____________________________________________________
Telephone Number: ___________________________________________________
Fax No. ____________________________________________________________
Email: _____________________________________________________________
Website: ___________________________________________________________
2.Which of the classifications of charitable objects do the primary purposes of the
organization relate to?
Advancement of Education
Health and Welfare
Relief of Poverty
Advancement of Religion
Other Charitable Purposes Beneficial to the community. Please specify sub-
category:
o Culture and Arts
o Enhancement of Youth
o Health and Welfare
o Public Safety Programs
o Amateur Sports Organizations
o Community Service Organizations
3.The following pre-requisites are mandatory to be considered eligible for a lottery
licence:
Has your organization been in existence for at least one (1) year?
No
Yes
Does your organization have a place of business in Ontario and can demonstrate
that it is established to provide charitable services in Ontario and use proceeds for
objects or purposes which benefit Ontario residents?
No
Yes
In order to determine eligible uses of proceeds, your organization must set out in
detail its proposed uses of proceeds and for which programs the proceeds will be
applied.
The organization's proposed use of proceeds must be for charitable programs and
the programs must be consistent with the charitable purposes and objects of the
organization. These purposes and objects must be of a charitable nature and fall
within at least one of the classifications listed above.
4.Is the organization incorporated as a non-profit organization with the Ministry of
Consumer and Business Services (Ontario)?
No
Yes
Registration date: __________________________
Registration number: ________________________
5.Is the organization registered with Revenue Canada as a charity?
No
Yes
Registration date: __________________________
Registration number: ________________________
6.How long has the organization been providing services? ____________________
7.What is the charitable purpose/mandate of the organization?
8.Approximate total number of members in the organization: ___________________
9.Date of fiscal year-end: _________
Please indicate last day of filing: _____________
10. Does the Organization currently manage and conduct any gaming event (lotteries) in
other municipalities?
No
Yes
Please indicate type of gaming event and municipality:
Bingo
Municipality: __________________________________
Raffle
Municipality: __________________________________
Break Open Ticket
Municipality: __________________________________
Bazaars
Municipality: __________________________________
Please include name and address of Supplier registered under Gaming Control Act,
1992: _____________________________________________________________
11. For the purpose of lottery licensing, all organizations must have a lottery trust
account. Please complete the following information:
Name of Financial Institution: ___________________________________________
Address of Financial Institution: _________________________________________
Trust Account Number: ________________________________________________
Date Opened: _______________________________________________________
Please attach the following information:
Incorporation Papers (Letters Patent)
Constitution and By-laws
Notification of Charitable Registration (Canada Customs and Revenue
Agency) (if applicable)
The most recent Registered Charity Information Return & Public Information
Return, as submitted to Canada Customs and Revenue Agency (if applicable)
Financial Statement for Previous Fiscal Year (audited, where applicable)
Detailed outline of all programs/services provided in the previous year and
specific costs incurred in delivery
The current operating budget
The current listing of the Board of Directors
Any other information that will assist in determining the charitable nature of
the objects and purposes. (This could include the annual report,
correspondence relating to its charitable number for income-tax purposes,
confirmation that it meets the reporting requirements of the Charities
Accounting Act
The proposed use of proceeds, which must be consistent with the primary
objects and purposes of the organization and of a charitable nature consistent
with at least one of the classifications of charitable purposes.
Minimum Constitution Requirements:
• Organization’s Name
• Objects and Purposes
• Clause stating that the organization shall be carried on without purpose of
gain for its members and any profits or other accretions to the organization
shall be used solely to promote its purposes
• Organization’s Structure
• A provision that explains how the organization will replace its officers and
directors
• The signatures of at least three of the organization’s current officers
• A clause that provides for the distribution of the property of the organization at
windup to charitable organizations which carry on their work for the benefit of
residents of Ontario that would also be eligible for charitable gaming licences
Designated Members in Charge
All Designated Members in Charge must be bona fide members of the organization
and are required to complete this form.
We, as active, bona fide members of _____________________________________
hereby certify that as the designated members in charge of the lottery for which this
application is made, will be responsible for the management and conduct of the
lottery in accordance with the terms and conditions under which the lottery licence is
issued. We, as bona fide members, have signing authority, hold a senior position
with the organization and will be present at the bingo event. (In addition to the three
bona fide members listed below, please include a list of two to three names,
including positions within the organization and telephone numbers (during the day)
in order to deal with scheduling and unscheduled absences.)
Print Name:
Title:
Other Position(s)
held in Organization:
Home Address:
Phone Number:
Date:
Signature:
Print Name:
Title:
Other Position(s)
held in Organization:
Home Address:
Phone Number:
Date:
Signature:
Print Name:
Title:
Other Position(s)
held in Organization:
Home Address:
Phone Number:
Date:
Signature:
Other Contacts:
Name Position Phone Number
1.
2.
3.