Nj Raffle Report Form PDF Details

The New Jersey Raffle Report form, as mandated by the state's Office of Attorney General Division of Consumer Affairs and the Legalized Games of Chance Control Commission, plays a crucial role in the governance of raffle activities within the state. Located in Newark, this commission oversees the filing of the Raffle Report of Operations, a requirement for all licensees conducting raffles, with the exception of instant raffle games and carnival games and wheels. This comprehensive form must be submitted no later than the 15th day of the month following the month in which the licensed activity occurred. The process necessitates detailed documentation of various aspects of the raffle events, including tickets sold, costs of prizes, gross receipts, and net proceeds. It also requires a certification from an officer or member of the organizing body, asserting the accuracy and completeness of the information provided, under the penalty of perjury. This filing can be made either on paper or electronically, with specific instructions for each method, including email submission for those completed online. Additionally, the form includes sections for reporting the schedule of expenses and the utilization of net proceeds, ensuring transparency and accountability in the conduct of raffle activities. The emphasis on detailed record-keeping and timely submission underscores the importance of compliance and the role of this document in upholding the integrity of raffle operations in New Jersey.

QuestionAnswer
Form NameNj Raffle Report Form
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesraffle report of operations, nj lgccc report of operations, legalized games of chance reports, how to new jersey raffle

Form Preview Example

New Jersey Office of Attorney General

Division of Consumer Affairs

Legalized Games of Chance Control Commission

124 Halsey Street, 6th Floor, P.O. Box 46000

Newark, New Jersey 07101

(973) 273-8000

Instructions for Filing the Rafle Report of Operations

PURSUANT TO N.J.A.C. 13:47-9.1, licensees must ile a report of operations with the Legalized Games of Chance

Control Commission (“Commission”) no later than the 15th day of the calendar month immediately following the calendar month in which the licensed activity was held, operated or conducted.

You may download this report and complete ALL of the entries for each occasion(s) relating to the conduct of all rafles, except for instant rafle games and carnival games and wheels. Once completed, a member/oficer shall certify that he/she has reviewed the report and that the information provided is true, accurate and complete. This will require the person to state their name and title, and sign the document before a notary public.

Rafle Report of Operations for the conduct of off-premises 50/50 or merchandise rafles must be submitted along with a printer’s certiicate and a sample ticket. All reports on paper are to be mailed to the Legalized Games of Chance Control Commission, P.O. Box 46000, Newark, New Jersey 07101.

However, for your convenience, we offer the ability to ile reports electronically via e-mail, EXCEPT FOR OFF- PREMISES 50/50 RAFFLES INVOLVING ADDITIONAL FEES. To employ this option, you must do a “SAVE AS” of the report, and place it onto your personal computer. Complete the report by using the “TAB” key to maneuver through each ield.

Upon completion, the member/oficer shall certify by placing a check in the box provided, that he/she has reviewed the report and that the information provided is true, accurate and complete. Subsequently, the person must state his/her name and title. Reports that are not properly certiied will be sent or e-mailed back.

Rafle Report of Operations completed online must be e-mailed to the Commission at PetermanA@dca.lps.state.nj.us.

It is recommended that you maintain a copy of all reports as part of the organization’s records.

New Jersey Office of Attorney General

Division of Consumer Affairs

Legalized Games of Chance Control Commission

124 Halsey Street, 6th Floor, P.O. Box 46000

Newark, New Jersey 07101

(973) 273-8000

Rafle Report of Operations

Please print clearly.Identiication number _____________________

Municipality ______________________________________ License number ____________________________

Name of licensee_____________________________________________________________________________

Organization

___________________________________________________________________________________________

Street addressCityStateZIP code

Location of games____________________________________________________________________________

This report, as required by N.J.S.A. 5:8-37 and N.J.A.C. 13:47-9, must be iled with the Legalized Games of

Chance Control Commission no later than the 15th day of the month following the conduct of the game(s) of chance.

Occasion 1

Date ____________________Time _____________________ Type of rafle ______________

1.

Number of tickets sold

___________

4. Cost of prizes

$ __________ Type of prize(s) _____________

2. Ticket price

 

$ ___________

5.

Supplies/Equipment cost

$ __________ __________________________

3.

Gross receipts

 

$ ___________

6.

Other expenses

$ __________

 

 

 

 

 

 

7. Total expenses

$ __________ 8. Net proceeds

$_________

 

 

 

Occasion 2

Date ____________________Time _____________________ Type of rafle ______________

1.

Number of tickets sold

___________

4.

Cost of prizes

$ __________ Type of prize(s) _____________

2. Ticket price

 

$ ___________

5.

Supplies/Equipment cost

$ __________ __________________________

3.

Gross receipts

 

$ ___________

6.

Other expenses

$ __________

 

 

 

 

 

 

7. Total expenses

$ __________ 8. Net proceeds

$_________

 

 

 

Occasion 3

Date ____________________Time _____________________ Type of rafle ______________

1.

Number of tickets sold

___________

4.

Cost of prizes

$ __________ Type of prize(s) _____________

2. Ticket price

 

$ ___________

5.

Supplies/Equipment cost

$ __________ __________________________

3.

Gross receipts

 

$ ___________

6.

Other expenses

$ __________

 

 

 

 

 

 

7. Total expenses

$ __________ 8. Net proceeds

$_________

 

 

 

Occasion 4

Date ____________________Time _____________________ Type of rafle ______________

1.

Number of tickets sold

___________

4.

Cost of prizes

$ __________ Type of prize(s) _____________

2. Ticket price

 

$ ___________

5.

Supplies/Equipment cost

$ __________ __________________________

3.

Gross receipts

 

$ ___________

6.

Other expenses

$ __________

 

 

 

 

 

 

7. Total expenses

$ __________ 8. Net proceeds

$_________

Occasion 5

Date ____________________Time _____________________ Type of rafle ______________

1. Number of tickets sold

___________

4.

Cost of prizes

$ __________ Type of prize(s) _____________

2. Ticket price

 

$ ___________

5.

Supplies/Equipment cost

$ __________ __________________________

3. Gross receipts

 

$ ___________

6.

Other expenses

$ __________

 

 

 

 

7. Total expenses

$ __________ 8. Net proceeds

$_________

 

 

Occasion 6

Date ____________________Time _____________________ Type of raffle ______________

1. Number of tickets sold

___________

4.

Cost of prizes

$ __________ Type of prize(s) _____________

2. Ticket price

 

$ ___________

5.

Supplies/Equipment cost

$ __________ __________________________

3. Gross receipts

 

$ ___________

6.

Other expenses

$ __________

 

 

 

 

7. Total expenses

$ __________ 8. Net proceeds

$_________

Total number of occasions

..................................

_________

 

 

Total number of tickets sold (1-6 combined)

_________

 

 

Price of tickets

 

 

$

________

 

 

Total gross proceeds (1-6 combined)

$

________

 

 

Total expenses (1-6 combined)

$

________

 

 

Total net proceeds (1-6 combined)

$

________

 

 

Date

Schedule of Expenses

Description

Check number

AMOUNT

 

 

 

Date

UTILIZATION OF NET PROCEEDS

Description

Check number

AMOUNT

 

 

 

BANK

NAME

Address where balance is deposited

Account number

Person Responsible for Use of Proceeds

NAME

Address

Telephone number

(include area code)

I certify that all of the statements on this report of operations are true, accurate and complete. I am aware that if any of the foregoing statements are willfully false, I am subject to punishment.

Prizes Offered or Awarded

Please list the prizes offered or awarded and their respective retail values.

Prizes Offered or Awarded

Retail Value

Prizes Offered or Awarded

Retail Value

N.J.S.A. 5:8-37 “It shall be the duty of each licensee to maintain and keep such books and records as may be necessary to substantiate the particulars of each such report.” Facts stated on this report are regarded as if made under oath.

I certify that I have reviewed this report and that the information on this report of operations is true, accurate and complete. I am aware that if any of the foregoing statements are willfully false, I am subject to punishment.

I certify by placing a check in this box, that I have reviewed the report and that the information provided is true, accurate and complete.

You must state your name and title below. Reports that are not properly certiied will be sent or e-mailed back.

_______________________________________

__________________________________________

Name and title of oficer (please print)

Signature of oficer

Sworn and subscribed to before me this __________

day of ______________________ , ____________

MonthYear

__________________________________________

Name of Notary Public (please print)

__________________________________________

Signature of Notary Public

Afix Seal Here

Form LGCCC 8R-A (Rev. 12/4/07)

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1. When filling out the nj instant raffle ticket report of operations, make certain to incorporate all needed fields within its associated form section. It will help speed up the process, allowing for your details to be processed fast and appropriately.

number type raffle completion process explained (step 1)

2. Once your current task is complete, take the next step – fill out all of these fields - Number of tickets sold Ticket, Cost of prizes Type of prizes, Net proceeds, Occasion, Date Time Type of rafle, Number of tickets sold Ticket, Cost of prizes Type of prizes, Net proceeds, Occasion, Date Time Type of rafle, Number of tickets sold Ticket, Cost of prizes Type of prizes, and Net proceeds with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

number type raffle writing process clarified (step 2)

3. Within this stage, look at Occasion Number of tickets sold, Date Time Type of rafle Cost, Net proceeds, Occasion Date Time Type of, Net proceeds, Total number of occasions Total, Date, Schedule of Expenses, Description, Check number, and Amount. These must be taken care of with greatest precision.

number type raffle conclusion process described (stage 3)

People who work with this form often make some mistakes when completing Description in this section. Don't forget to read twice what you type in here.

4. It's time to start working on the next portion! In this case you will have all of these Date, Description, Check number, Date, Description, Check number, Amount, and Utilization of Net Proceeds form blanks to complete.

Part no. 4 in submitting number type raffle

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The right way to fill in number type raffle portion 5

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