Form RCG-1-E Charitable Games, Bingo, or Pull Tabs Events Updates - Illinois

Form RCG-1-E or the "Charitable Games, Bingo, Or Pull Tabs Events Updates" is a form issued by the Illinois Department of Revenue.

Download a PDF version of the Form RCG-1-E down below or find it on the Illinois Department of Revenue Forms website.

ADVERTISEMENT
Illinois Department of Revenue
RCG-1-E
Charitable Games, Bingo, or Pull Tabs Events Updates
Register faster using MyTax Illinois, our online account management program, available on our website at tax.illinois.gov. If you have
questions, visit our website or call us weekdays between 8:00 a.m. and 4:30 p.m. at 217 785-5864 or email at rev.bptcg@illinois.gov. Mail
your completed information to OFFICE OF BINGO AND CHARITABLE GAMES, ILLINOIS DEPARTMENT OF REVENUE, PO BOX 19480,
SPRINGFIELD IL 62794-9480.
Step 1: Check the box that best describes why you are completing this schedule
Complete this form only if you need to provide or change required information about your events and you hold a license for one of the following:
charitable games, pull tabs and jar games, or bingo. Note: The information must be submitted no less than 30 days prior to the event.
Add an event or events
Change event or events previously scheduled
Step 2: Identify your organization
Organization name: ______________________ Account license number: ______________________ FEIN: ______________________
Step 3: Provide the following information for your licensed events
3
Charitable Games
- You must also complete and retain in your records Forms RCG-2 and RCG-10 for each of the events listed below.
a.m.
a.m.
a.m.
a.m.
a
_____/_____/_____ _____ : _____
to _____ : _____
c _____/_____/_____
_____ : _____
to _____ : _____
p.m.
p.m.
p.m.
p.m.
Month
Day
Year
Hour
Minute
Hour
Minute
Month
Day Year
Hour
Minute
Hour
Minute
_____________________________________________________
_____________________________________________________
Street address - No PO Box number
Apartment or suite number
Street address - No PO Box number
Apartment or suite number
_____________________________________________________
_____________________________________________________
City
County
State
ZIP
City
County
State
ZIP
Do you own or occupy this premises? ____Yes
_____No
Do you own or occupy this premises? ____Yes
_____No
If no, enter the provider of premises license. CP-______________
If no, enter the provider of premises license. CP-_______________
a.m.
a.m.
a.m.
a.m.
b _____/_____/_____ _____ : _____
to _____ : _____
d _____/_____/_____
_____ : _____
to _____ : _____
p.m.
p.m.
p.m.
p.m.
Month
Day
Year
Hour
Minute
Hour
Minute
Month
Day Year
Hour
Minute
Hour
Minute
_____________________________________________________
_____________________________________________________
Street address - No PO Box number
Apartment or suite number
Street address - No PO Box number
Apartment or suite number
_____________________________________________________
_____________________________________________________
City
County
State
ZIP
City
County
State
ZIP
Do you own or occupy this premises? ____Yes
_____No
Do you own or occupy this premises? ____Yes
_____No
If no, enter the provider of premises license. CP-_______________
If no, enter the provider of premises license. CP-_______________
4
Tell us about the gambling equipment used in your charitable games events.
a
Does your organization own any of the gambling equipment you will use in your charitable games event? _____ Yes _____ No
b
If “yes,” you must complete Form RCG-9. If “no,” provide the following information for all persons or organizations from whom you will
purchase, lease, rent, or borrow any gambling equipment used at your charitable games event. Attach additional sheets if necessary.
___________________________________________________
___________________________________________________
Name
Name
___________________________________________________
___________________________________________________
Street address - No PO Box number
City
State
ZIP
Street address - No PO Box number City
State
ZIP
Supplier’s license number CS-__________________________
Supplier’s license number CS-__________________________
or if borrowed, charitable games license no. CG-____________
or if borrowed, charitable games license no. CG-____________
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
5
Pull Tabs and Jar Games
Special Permit
Event date:____/____/_____ to ____/____/_____
Month Day
Year
Month
Day
Year
Event location: _______________________________________________________________________________________________
Street address-No PO Box
City
County
State
ZIP
RCG-1-E front (R-08/15)
Illinois Department of Revenue
RCG-1-E
Charitable Games, Bingo, or Pull Tabs Events Updates
Register faster using MyTax Illinois, our online account management program, available on our website at tax.illinois.gov. If you have
questions, visit our website or call us weekdays between 8:00 a.m. and 4:30 p.m. at 217 785-5864 or email at rev.bptcg@illinois.gov. Mail
your completed information to OFFICE OF BINGO AND CHARITABLE GAMES, ILLINOIS DEPARTMENT OF REVENUE, PO BOX 19480,
SPRINGFIELD IL 62794-9480.
Step 1: Check the box that best describes why you are completing this schedule
Complete this form only if you need to provide or change required information about your events and you hold a license for one of the following:
charitable games, pull tabs and jar games, or bingo. Note: The information must be submitted no less than 30 days prior to the event.
Add an event or events
Change event or events previously scheduled
Step 2: Identify your organization
Organization name: ______________________ Account license number: ______________________ FEIN: ______________________
Step 3: Provide the following information for your licensed events
3
Charitable Games
- You must also complete and retain in your records Forms RCG-2 and RCG-10 for each of the events listed below.
a.m.
a.m.
a.m.
a.m.
a
_____/_____/_____ _____ : _____
to _____ : _____
c _____/_____/_____
_____ : _____
to _____ : _____
p.m.
p.m.
p.m.
p.m.
Month
Day
Year
Hour
Minute
Hour
Minute
Month
Day Year
Hour
Minute
Hour
Minute
_____________________________________________________
_____________________________________________________
Street address - No PO Box number
Apartment or suite number
Street address - No PO Box number
Apartment or suite number
_____________________________________________________
_____________________________________________________
City
County
State
ZIP
City
County
State
ZIP
Do you own or occupy this premises? ____Yes
_____No
Do you own or occupy this premises? ____Yes
_____No
If no, enter the provider of premises license. CP-______________
If no, enter the provider of premises license. CP-_______________
a.m.
a.m.
a.m.
a.m.
b _____/_____/_____ _____ : _____
to _____ : _____
d _____/_____/_____
_____ : _____
to _____ : _____
p.m.
p.m.
p.m.
p.m.
Month
Day
Year
Hour
Minute
Hour
Minute
Month
Day Year
Hour
Minute
Hour
Minute
_____________________________________________________
_____________________________________________________
Street address - No PO Box number
Apartment or suite number
Street address - No PO Box number
Apartment or suite number
_____________________________________________________
_____________________________________________________
City
County
State
ZIP
City
County
State
ZIP
Do you own or occupy this premises? ____Yes
_____No
Do you own or occupy this premises? ____Yes
_____No
If no, enter the provider of premises license. CP-_______________
If no, enter the provider of premises license. CP-_______________
4
Tell us about the gambling equipment used in your charitable games events.
a
Does your organization own any of the gambling equipment you will use in your charitable games event? _____ Yes _____ No
b
If “yes,” you must complete Form RCG-9. If “no,” provide the following information for all persons or organizations from whom you will
purchase, lease, rent, or borrow any gambling equipment used at your charitable games event. Attach additional sheets if necessary.
___________________________________________________
___________________________________________________
Name
Name
___________________________________________________
___________________________________________________
Street address - No PO Box number
City
State
ZIP
Street address - No PO Box number City
State
ZIP
Supplier’s license number CS-__________________________
Supplier’s license number CS-__________________________
or if borrowed, charitable games license no. CG-____________
or if borrowed, charitable games license no. CG-____________
-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
5
Pull Tabs and Jar Games
Special Permit
Event date:____/____/_____ to ____/____/_____
Month Day
Year
Month
Day
Year
Event location: _______________________________________________________________________________________________
Street address-No PO Box
City
County
State
ZIP
RCG-1-E front (R-08/15)
5 Pull Tabs and Jar Games - continued
Limited License
a
b
First event:_____/_____/_____ to _____/_____/_____
Second event:_____/_____/_____ to _____/_____/_____
Month
Day
Year
Month
Day
Year
Month
Day
Year
Month
Day
Year
___________________________________________________
___________________________________________________
Street address - No PO Box number
Apartment or suite number
Street address - No PO Box number
Apartment or suite number
___________________________________________________
___________________________________________________
City
State
ZIP
City
State
ZIP
___________________________________________________
___________________________________________________
County
County
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
6
Bingo
Special Permit
a
b
First event:_____/_____/_____ to _____/_____/_____
Second event:_____/_____/_____ to _____/_____/_____
Month
Day
Year
Month
Day
Year
Month
Day
Year
Month
Day
Year
At what time will bingo begin and end:
At what time will bingo begin and end:
a.m.
a.m.
a.m.
a.m.
_____ : _____
to _____ : _____
_____ : _____
to _____ : _____
p.m.
p.m.
p.m.
p.m.
Hour
Minute
Hour
Minute
Hour
Minute
Hour
Minute
___________________________________________________
___________________________________________________
Limited License
a
b
First event:_____/_____/_____ to _____/_____/_____
Second event:_____/_____/_____ to _____/_____/_____
Month
Day
Year
Month
Day
Year
Month
Day
Year
Month
Day
Year
At what time will bingo begin and end:
At what time will bingo begin and end:
a.m.
a.m.
a.m.
a.m.
_____ : _____
p.m.
to _____ : _____
p.m.
_____ : _____
p.m.
to _____ : _____
p.m.
Hour
Minute
Hour
Minute
Hour
Minute
Hour
Minute
___________________________________________________
___________________________________________________
Street address - No PO Box number
Street address - No PO Box number
Apartment or suite number
Apartment or suite number
___________________________________________________
___________________________________________________
City
State
ZIP
City
State
ZIP
___________________________________________________
___________________________________________________
County
County
Is this location owned or occupied by your organization
Is this location owned or occupied by your organization
or a unit of local government? ___Yes ___ No
or a unit of local government? ___ Yes ___ No
If no, enter the bingo provider of premises license number.
If no, enter the bingo provider of premises license number.
BP-__________
BP-__________
Step 4: Sign below
Under the penalties of perjury, I state that I have examined this application and all attachments and other information required and to the best of
my knowledge, it is true, correct, and complete. I certify that I will follow Illinois laws and regulations when conducting event or events under my
license.
________________________________________________________________________________________________________________
Signature
Printed name
Date
This form is authorized as outlined under the tax or fee Act imposing the tax or fee for which this form is filed. Disclosure of this information is required. Failure to provide
information may result in this form not being processed and may result in a penalty.
RCG-1-E back (R-08/15)

Download Form RCG-1-E Charitable Games, Bingo, or Pull Tabs Events Updates - Illinois

1144 times
Rate
4.6(4.6 / 5) 80 votes
ADVERTISEMENT
Page of 2