Lottery Returns Form - Taunton Deane Borough Council printable pdf download

Lottery Returns Form - Taunton Deane Borough Council

The Licensing Unit, Taunton Deane

FORM: G28

Borough Council, The Deane House,

Case Ref. No:

Belvedere Road, Taunton, Somerset.

(Office use only)

TA1 1HE.

Return relating to a Small Society Lottery

Gambling Act 2005 – Schedule 11, Part 4

The following information is required by Schedule 11, Part 4, Paragraph 39(2) of the Gambling Act 2005. This

statement must be submitted no later than three months beginning on the day on which the draw (or last

draw) in the lottery took place. It must be signed by two members of the Society appointed in writing for that

purpose by the Society, or its governing body if applicable, and accompanied by a copy of that appointment.

All signatories must be over the age of 18 years.

We, being duly appointed members of the Society in compliance with the requirements of Schedule 11, Part 4,

Paragraph 39(4), hereby submit the following statutory return:

Name of Society:

Licensing Authority issued Registration number of

Society:

Arrangements for the lottery, including:

(a)

Dates on which tickets were available for

(a)

sale or supply;

(b)

Dates of any draw;

(b)

(c)

Arrangements for prizes, including any

(c)

rollover; and

(d)

Details of any donated prizes:

(d)

Proceeds of the Lottery:

Amounts deducted by the promoters of the lottery

in respect of the provision of prizes (including the

provision of any prizes in accordance with any

rollover):

Amounts deducted by the promoters of the lottery

in respect of other costs incurred in organising the

lottery:

Any amount applied to a purpose for which the

promoting Society is conducted:

Whether any expenses in connection with the

lottery were paid otherwise than by deduction from

proceeds, and, if they were –

(i)

the amount of the expenses, and

(ii)

the sources from which they were paid

Lottery Returns Form - Taunton Deane Borough Council

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