Form 201 - R - Charitable Gaming Permit Application Renewal Applicants Only Page 11
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12STAND ALONE RAFFLE REQUIREMENTS
Information requested in this form must accompany the organization's application, or amendment request, if a stand alone raffle is
conducted. Please complete this form in its entirety for each stand alone raffle event the organization intends to conduct.
Raffle Tickets
Attach a sample copy of each stand alone raffle ticket.
Each raffle ticket must conform to the requirements of 11 VAC 15-22-70.C. of the Charitable Gaming Rules and Regulations, including,
but not limited to, raffle tickets being sequentially numbered and having a detachable section, with one portion going to the seller and
the other portion to the purchaser.
The portion that goes to the Purchaser must
The portion that is retained by the Seller must include:
include, but is not limited to:
The purchasers name, complete address, and
The ticket number.
contact telephone number.
The selling price of each ticket.
The matching sequential ticket number to the
The prize(s) to be awarded.
portion provided to the purchaser.
The date, time, and name/address of
the physical location of the drawing.
The name, address and telephone
number of the organization.
The charitable gaming permit number
(after issuance by the Department).
NOTE: Raffle tickets may not be printed until the organization is authorized in writing to do so by OCRP.
Raffle Narrative
Please use a separate sheet to answer the following questions.
Please provide a written narrative describing how the organization will conduct the raffle. Please be very specific and detailed. This
narrative must include, but is not limited to, the following:
Part 1 - Scope and Purpose of Raffle
A.
How many raffle tickets will be printed?
B.
How much will each raffle ticket cost?
$
C.
What are the anticipated GROSS receipts (Multiply Line A by Line B)
=
D.
What will happen if the raffle is not successful such as not all of the tickets are sold to pay for the raffle prize?
E.
Please provide any other information pertinent to the scope and purpose of the raffle.
Part 2 - Sales Distribution
A.
How will the money be controlled?
B.
How will the tickets be handled?
C.
How exactly will the tickets be sold to the purchaser and how will the money be collected?
D.
Does the organization anticipate selling tickets outside of the Commonwealth of Virginia? If yes, please provide a copy of the
permit authorizing the organization to sell tickets in each applicable state.
E.
11 VAC 15-22-70.C. of the Charitable Gaming Rules and Regulations states, "[w]inning tickets and unsold tickets shall be maintained for three
years from the close of the fiscal year." Where does the organization plan to store these unsold and winning raffle tickets during this three year
time frame?
F.
Please provide any other information pertinent to the sales distribution of the raffle ticket(s).
Part 3 - Drawing Process and Prize Winners
A.
Who will conduct the raffle drawing?
B.
Describe the drawing process.
C.
How will the prizes be distributed? Does the winner need to be present? How many days does the winner have to claim the prize? What
happens if the winner does not claim the prize?
Please provide any other information pertinent to the drawing process and/or prize winners of the raffle ticket(s).
D.
Other Required Information
A.
Attach a copy of the "House Rules" for each stand alone raffle. 11 VAC 15-22-50.A. of the Charitable Gaming Rules and Regulations state,
"Each organization shall adopt "House Rules" regarding conduct of the game. Such rules shall be consistent with the provisions of the law and
[the Charitable Gaming] regulations. "House Rules" shall be conspicuously posted or, at an organization's option, printed on the game program
[raffle ticket]."
B.
Provide a letter of intent from the individual(s) or business(es) from which the prize(s) are being purchased/donated stating the terms and
conditions of the transaction(s). The letter needs to be written on the business(es) letterhead, signed, and dated. It should address the fair
market value of the item if it is being donated or the actual cost if it will be purchased by the organization. If the organization already owns and
has title to the prize, a copy of the original bill of sale will suffice.
C.
If applicable, provide a copy of the written lease and/or agreement between the organization and the owners of the property where the drawing
will take place.
All organizations are responsible for ensuring compliance with all State and Federal laws in the conduct of their charitable gaming activities.
D.
Charitable Gaming Permit Application - Renewal Applicants Only
Rev. 07/30/13
Page 11 of 12
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