Organization Eligibility Application and Questionnaire

To be considered for Charitable Gaming, the organization must qualify as an eligible organization by meeting specific criteria set out by the Alcohol and Gambling Commission of Ontario (AGCO) Regulations. 

Please complete the following questionnaire, to be reviewed by a Licensing Officer who will determine your organization's eligibility.

To be eligible for a lottery licence, an applicant must qualify either as an eligible charitable organization or as a non-profit organization with charitable purposes or objects.

In order to qualify for a lottery licence, an organization must demonstrate that its primary mandate is to provide services in one of four charitable classifications:

Organization Information

Lottery licence holders are required to have a lottery trust account used only for the purposes of conducting lotteries. If the organization has an open lottery trust account, please complete the following information:

Signature

By signing below, I confirm: 

• I have signing authority for the organization. 
• I confirm that the above information is true to the best of my knowledge and that I have made every effort to provide accurate information to determine eligibility for applying for a lottery licence with the Municipality of Trent Hills. I understand that false information may prevent the organization from obtaining a lottery licence with the Municipality of Trent Hills now and in the future. 

Enclosures

Please attach the following documents to this application:

• Incorporation Papers (Letters Patent) – attach signature page
• Constitution and By-Laws
• Notification of Charitable Registration (Canada Customs and Revenue Agency) (if applicable)
• Most recent Registered Charity Information Return and Public Information return as submitted to Canada Customs and Revenue Agency (if applicable)
• Financial Statement for the previous year
• Detailed outline of all programs and services provided in the last 12 months and costs associated
• Current operating budget (i.e. admin costs, staffing, utilities, rental fees, etc.)
• Currently list of Board of Directors and Designated Members in charge
• Proposed use of proceeds
• A clause stating that the organization’s members will not derive any gain from the organization and that any profits will be used solely to promote the organization's objectives
• A general dissolution clause that addresses the winding up of the organization. A further clause (which may be contained in the bylaws) that, if the organization should dissolved, provides for the distribution of the organization's assets and property held or acquired from the proceeds of licensed lottery events (that is, lottery trust accounts or property purchased with lottery proceeds) to charitable organizations that are eligible to receive lottery proceeds in Ontario
• Any other information that would assist the Administrator in determining charitable cause.

Notice of Collection: Personal information contained on this form is collected pursuant to the Municipal Act, and will be used for lottery purposes only.  Enquiries regarding the collection of this information may be directed to the Office of the Clerk/Freedom of Information Coordinator, Municipality of Trent Hills, 66 Front Street South, Campbellford, ON K0L 1L0 705-653-1900.