"Application for a New or Renewal Class a and B License to Operate Raffle Games" - Oregon

Application for a New or Renewal Class a and B License to Operate Raffle Games is a legal document that was released by the Oregon Department of Justice - a government authority operating within Oregon.

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OREGON DEPARTMENT OF JUSTICE
CHARITABLE ACTIVITIES SECTION
APPLICATION FOR A NEW OR RENEWAL
A
B
CLASS
AND
LICENSE TO OPERATE RAFFLE GAMES
IMPORTANT NOTICE – READ CAREFULLY
Raffle Games possess inherent risks for gaming licensees. Not all raffle games are successful
fundraisers. Your organization should carefully consider its marketing plan to ensure that you have
sufficient volunteers and employees to sell enough tickets to make your raffle a successful event.
Once you commence ticket sales, under Oregon law you are generally required to co mp lete th e
raffle event and award the prize regardless of how many tickets you sell. You generally cannot
cancel the raffle once you begin raffle ticket sales. ORS 646.608 the “Oregon Unlawful Trade
Practices Act” prohibits making false statements about a prize, contest or promotion; or advertising
real estate, goods or services with intent not to provide them as advertised; or promising to deliver
real estate, goods or services with intent not to deliver them.
High end items such as motor vehicles are especially risky. Even if you do not sell as many tickets as
you hope to, you must still hold the event and award the prize. Your raffle might not generate a prof it
for your organization.
Your organization must own the advertised raffle prize. In the case of motor vehicles, this means that
your organization must furnish the Department with a copy of a clear title to the vehicle. If the vehicle
is a used or custom vehicle, you must provide a written appraisal verifying its advertised value and
mileage by an authorized appraiser. If new, submit copy of dealer sales invoice and/or purchase
contract.
Any raffles offering a prize of cider, distilled liquor, malt, beverage or wine must also adhere to
the raffle regulations of the Oregon Liquor Control Commission. Any raffles offering a prize o f
a firearm must also adhere to the regulations of the Bureau of Alcohol, Tobacco, Firearms and
Explosives.
See instructions on next page
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Page 1 of 12
OREGON DEPARTMENT OF JUSTICE
CHARITABLE ACTIVITIES SECTION
APPLICATION FOR A NEW OR RENEWAL
A
B
CLASS
AND
LICENSE TO OPERATE RAFFLE GAMES
IMPORTANT NOTICE – READ CAREFULLY
Raffle Games possess inherent risks for gaming licensees. Not all raffle games are successful
fundraisers. Your organization should carefully consider its marketing plan to ensure that you have
sufficient volunteers and employees to sell enough tickets to make your raffle a successful event.
Once you commence ticket sales, under Oregon law you are generally required to co mp lete th e
raffle event and award the prize regardless of how many tickets you sell. You generally cannot
cancel the raffle once you begin raffle ticket sales. ORS 646.608 the “Oregon Unlawful Trade
Practices Act” prohibits making false statements about a prize, contest or promotion; or advertising
real estate, goods or services with intent not to provide them as advertised; or promising to deliver
real estate, goods or services with intent not to deliver them.
High end items such as motor vehicles are especially risky. Even if you do not sell as many tickets as
you hope to, you must still hold the event and award the prize. Your raffle might not generate a prof it
for your organization.
Your organization must own the advertised raffle prize. In the case of motor vehicles, this means that
your organization must furnish the Department with a copy of a clear title to the vehicle. If the vehicle
is a used or custom vehicle, you must provide a written appraisal verifying its advertised value and
mileage by an authorized appraiser. If new, submit copy of dealer sales invoice and/or purchase
contract.
Any raffles offering a prize of cider, distilled liquor, malt, beverage or wine must also adhere to
the raffle regulations of the Oregon Liquor Control Commission. Any raffles offering a prize o f
a firearm must also adhere to the regulations of the Bureau of Alcohol, Tobacco, Firearms and
Explosives.
See instructions on next page
R App (June '18)
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Page 1 of 12
I
NSTRUCTIONS
Enclosed is an application for a license to conduct raffles in Oregon. This application may be used to apply for
a new license, and renew or upgrade an existing license. Raffle licenses are available to qualifying nonprofit
organizations. Only nonprofit organizations that meet the following requirements qualify for licenses:
The organization must be exempt from the payment of federal income tax; and
The organization must have held tax exempt status for a period of at least one year.
If your organization meets the qualifications above, and intends to conduct limited raffle operations, it may not
need a license. Licenses are not required if:
The organization conducts raffles with not more than $10,000 handle (gross sales) per any calendar year;
and/or
Your total ANNUAL handle is $10,000 or less.
If you anticipate that any single raffle may bring in more than $10,000, and/or your annual handle will exceed
$10,000, you should apply for a license. The license application is, for the most part, self-explanatory. Please
type or use ink to complete the application. Complete all items fully. Parts of the application may call for an
original signature by a responsible official. Applications that are incomplete or are not accompanied by original
signatures will be rejected. Once a complete application is filed, the Department has 60 days to approve or
deny the application. You will be notified in writing if your application is rejected or denied.
Proof must be provided that the applicant organization has held tax exempt status for at least one year along
with this application. Public schools or government agencies do not need to provide proof of tax exemption.
The following will be accepted by the Department as proof of tax exempt status:
A determination letter from the IRS stating that your organization is tax exempt.
A copy of the IRS group exemption letter, if you are claiming to be tax exempt under a group exemption.
You must provide documentation that shows the applicant organization is a subordinate organization
covered by the group exemption.
A copy of the filed SEL 221 or FEC Form 1 and a copy of the filed IRS Form 1120 POL, if the applicant
organization is claiming tax exempt status as a political action committee.
If the applicant organization is claiming tax exempt status other than pursuant to the provisions of the
Internal Revenue Code section 501(c), a signed opinion letter from an attorney or certified public
accountant that states the organization is tax exempt and which cites the relevant provisions of the Internal
Revenue Code which supports the claim for tax exempt status.
The following items will NOT be accepted as proof of tax exempt status:
IRS Form - Assignment of Employer or Taxpayer Identification Number.
Any articles of association or incorporation, or corporation listings which indicate solely that the
organization is registered as a nonprofit entity.
Educational institutions must have their school principal, district superintendent, dean, or school president
certify that the institution or division thereof is authorized to conduct raffles.
License Fees. The application must be accompanied by the proper license fee. All fees are non-refundable.
The fee for a Class A license is $100. The fee for a Class B license is $40. Make a check payable to Oregon
Department of Justice. The authorized handle limit for a Class B licensee is $10,000. There is no handle limit
for a Class A license.
If you have any questions concerning the application or the licensing process, contact the Gaming Registrar
Mail the completed report with fees to:
Oregon Department of Justice
Phone: (971) 673-1880
Make a check payable to
100 SW Market Street
Fax: (971) 673-1882
Oregon Department of Justice.
Portland, OR 97201-5702
TTY: (800)735-2900
(Original must be sent)
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DOJ USE ONLY
DOJ USE ONLY
Fee Paid
OREGON DEPARTMENT OF JUSTICE
Date Received
CHARITABLE ACTIVITIES SECTION
APPLICATION FOR A NEW OR RENEWAL
CLASS A AND B LICENSE TO OPERATE RAFFLE GAMES
Class, Limit and Fee
Applying for:
New License
License Renewal
License Upgrade
License class:
Non-refundable fee:
Class A authorizes raffles without restriction as to handle.
$100
Class B authorizes raffles with handles NOT to exceed $10,000 per raffle.
$40
Organization Information EIN:
Licensee # : R-
Full name of organization applying for raffle gaming license:
1
Mailing address:
City:
State:
ZIP:
Telephone:
Email:
R
C
4.
AFFLE
ONTACT BELOW MUST BE A RESPONSIBLE OFFICIAL AS DESIGNATED ON PAGE
Name (Last, First and Middle Initial):
2
Contact person address:
City:
State:
ZIP:
Contact person Phone:
Cell Phone:
Email:
Type of organization of applicant:
3
Charitable
Religious
Scientific
Fraternal
Labor
School/College
Government
Other:
State the purpose for which your organization intends to use the proceeds from raffles.
4
Has your organization held TAX EXEMPT status for at least one year?
5
YES
NO
Is the application organization a chapter or division of a larger or parent organization?
6
YES
NO
If #6 is YES, are you claiming Tax Exempt status under a group exemption letter
7
issued to the larger or parent organization?
YES
NO
If #6 is YES, does the applicant organization file an IRS Form 990 each year,
8
separately from the larger or parent organization?
YES
NO
New Applicants Only
Attach copy of your Tax Exempt Determination Letter from the IRS, or letter from Attorney or CPA
State organization is exempt, citing relevant provision of the Internal Revenue Code.
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Responsible Officials:
List the full legal name (including middle initial) for all of the organization’s responsible officials
who hold authority for governing the organization’s operations. Include volunteers, all members
of the Board of Directors, Executive Committee, the highest-ranking senior staff making day-to-
day decisions, etc. Must include the organization’s Chief Executive Officer (CEO) or equivalent.
YOU MAY ATTACH A LIST SUPPLYING THE REQUIRED INFORMATION.
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
9
Telephone:
Cell Phone:
Email:
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
10
Telephone:
Cell Phone:
Email:
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
11
Telephone:
Cell Phone:
Email:
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
12
Telephone:
Cell Phone:
Email:
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
13
Telephone:
Cell Phone:
Email:
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
14
Telephone:
Cell Phone:
Email:
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
15
Telephone:
Cell Phone:
Email:
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
16
Telephone:
Cell Phone:
Email:
Name: (Last, First, Middle Initial)
Title:
Address:
City:
State:
ZIP:
17
Telephone:
Cell Phone:
Email:
Attach additional sheet(s) if necessary.
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Legal History
Does the organization currently hold or has it ever held a Gaming License issued by the Oregon Department of Justice?
YES
NO
If YES, enter BINGO LICENSE#:
or RAFFLE LICENSE#:
or MONTE CARLO LICENSE #:
18
Current Status:
Open
Open
Open
Closed
Closed
Closed
Has the organization ever been denied a bingo, raffle, lottery, Monte Carlo event, or other gaming license/permit or has any
government agency, in this state or any other state ever revoked a bingo, raffle, lottery, Monte Carlo event, or other gaming
license/permit issued to the organization? (Renewal Applicants: Report only actions taken since previous application.)
YES
NO If YES, provide the name the organization was using at the time the above action was taken,
plus the date of the action, and the name of the agency that took the action.
19
Organization name (if different):
Action taken:
Date of action:
Agency name:
City:
State:
Has any official action ever been taken against the organization for any violation involving illegal gambling, or other gaming
violations in this state or any other state? (Renewal Applicants: report only actions taken since previous application.)
YES
NO If YES, provide the name the organization was using at the time the above action was taken
plus the date of the action, and the name of the agency that took the action.
Organization name (if different):
20
Action taken:
Date of action:
Agency name:
City:
State:
How often does the applicant organization’s governing board meet?
21
Monthly
Quarterly
Annually
Other (specify):
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