To be completed by all Key Persons as described by the Act

APPLICATION INSTRUCTIONS

PLEASE READ ALL INSTRUCTIONS CAREFULLY BEFORE COMPLETING THIS FORM.

COMPLETING THIS FORM:

1. You must make accurate statements and include all material facts. Any misrepresentation, or the failure to provide requested information, may result in the denial of your
2. Read each question carefully prior to answering. Answer every question completely. Do not leave blank spaces. If a question does not apply to you, indicate “Does Not Apply” in response to that question. If there is nothing to disclose in response to a particular question, indicate “None” in response to that question. Failure to provide a response to every question could result in the rejection of your application.
3. All entries on this form, except initials and signatures, must be typed or printed in block lettering using blue ink. If your application is not legible, it will not be
4. If the space available is insufficient to respond to a question, you are to supply the required information on an attachment page and clearly identify which question you are
5. If you make any modification to the pre-printed questions or information contained in this form, your application will be Once your application is accepted, it becomes the property of the Gambling (Betting and Gaming) Control Commission (the Commission).

BEFORE YOU SUBMIT THIS FORM TO THE COMMISSION BE SURE THAT:

1. You have reviewed the filing instructions for the type of license, approval or qualification that you are seeking.
2. You have included all required attachments listed in this form.
3. The Statement of Truth form is notarized on the original application.
4. Every question has been answered completely.
5. You retain a completed copy of your application package for your own records.
6. You have completed all ancillary forms.
   
   INFORMATION VERIFICATION

1. The Gambling Control Commission (the Commission) must consider whether an applicant is suitable to be granted a license by verifying the background information provided and ensuring the existence of adequate financial resources to efficiently operate a gambling business in a manner consistent with the licensing objectives of the Gambling (Betting and Gaming) Control Act No. 8 of 2021 and the attendant legislation.
2. An application will not be considered until ALL questions have been satisfactorily answered and the application fee has been paid in full.
3. The Commission may request any additional information considered necessary to determine the suitability of the applicant for a license.

IMPORTANT

FAILURE TO ANSWER ANY QUESTION ON THIS FORM COMPLETELY AND TRUTHFULLY WILL RESULT IN DENIAL OF YOUR APPLICATION.

Pursuant to the Gambling (Gaming and Betting) Control Act No. 8 of 2021

PERSONAL INFORMATION (DECLARANT)

CONTACT INFORMATION:

FEES TO BE SUBMITTED WITH THIS APPLICATION
(Please ensure that the applicable fees are paid to the Gambling Control Commission in advance. All amounts are stated in TTD.)

DECLARATION AND SIGNATURE (MUST BE COMPLETED)