Lottery Licensing Eligibility Form

Municipal address
Type of Lottery for which this application is being made (check one):
Is the applicant incorporated as a non-profit organization in the Province of Ontario?
Is the APPLICANT registered with Canada Customs and Revenue Agency as a charitable organization?
The Applicant Organization Lottery Trust Account (if open at this time)
NOTE: It will be required at the time of application.
Financial institution address
The designated member of the organization who will be responsible for keeping and maintaining records of all financial transactions pertaining to the licensed lottery activities:
Business address
Names of bona fide members who will conduct one or more of the lottery events referred to on this application:
NameName
1.
6.
2.
7.
3.
8.
4.
9.
5.
10.
We, the undersigned, declare that all information provided in and with this statement is factual and correct.
Mandatory Documents – Checklist to Determine Eligibility
In order to obtain a lottery licence, organizations must first be deemed eligible for licensing. Please submit the following documentations for review:
  • 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
     
  • Detailed outline of all programs/service currently provided and specific costs incurred in delivery
     
  • The current operating budget
     
  • 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 an 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 four classifications of charitable purposes:
    • The Relief of Poverty
    • The Advancement of Education
    • The Advancement of Religion
    • Any Purpose Beneficial to the Community
      • The Nature of Culture and the Arts
      • The Nature of Health and Welfare
      • Sports Organizations
      • Public Amenities
      • Service Clubs
Information taken from the Alcohol and Gaming Commission of Ontario’s Lottery Licensing Policy Manual and Lottery Licence Terms and Conditions

Please bring the checklist documentation to the Township office at 636 St. Lawrence St, Winchester after you submit the online form.