Charity Gaming Forms
The new forms listed below comply with the new statute that took effect on July 1, 2019.
QUALIFICATIONS (Your organization must first qualify to be eligible to conduct any charity gaming events)
| Form Identifier | Title | Use |
|---|---|---|
| CG-QA | Qualification Application | The qualification application is an organizations first step when they wish to conduct a charity gaming activity. The CG-QA must be completed and submitted along with the required attachments. |
ANNUAL ACTIVITIES (License issued for a period of twelve (12) months)
| Form Identifier | Title | Use |
|---|---|---|
| CG-AL | Application for Annual Activity License | The Annual License Application is used when an organization would like to conduct charity gaming activities on a regular basis. Such as holding bingo activities every Thursday. The license, when issued, will be valid for a one-year ongoing period. |
SINGLE ACTIVITIES (A one-time activity)
| Form Identifier | Title | Use |
|---|---|---|
| CG-SL | Application for Single Activity License | The Single Activity License Application is used when an organization would like to conduct a charity gaming activity once every so often, not on a regular basis. The single activity license will be valid for 1 day and 1 time frame. |
| CG-EN | Exempt Activity Notification | The Exempt Activity Notification form may be used when an organization would like to conduct a charity gaming activity once every so often and the charity gaming activity prize/payouts for a single activity are $2,500 or less and they have not reached the $7,500 annual max. |
| CG-FES | Application for Festival License | The Festival License is available for organizations who would like to conduct multiple types of charity gaming activities on more than one day. This license can be used to hold activities up to 5 consecutive days at one location. |
| CG-CVN | Application for Convention Raffle License | Organizations who are located outside the State of Indiana have an opportunity to conduct raffle activities only by using this application. The organization may conduct raffle activities at their conference at an Indiana convention center or at a location approved by the executive director. |
| CG-CCA | Candidate's Committee Application | Candidate’s committees may apply to conduct raffle activities by using this form. A copy of the candidate's CFA-1 form or equivalent must be attached. |
SCHEDULES
| Form Identifier | Title | Use |
|---|---|---|
| CG-SCHEDULE A | Operator Attachment | The schedule A form will need to be completed when applying for a license to list those individuals who are members of your organization for a minimum of 60 days and are in control of the gaming activity. (Non-member paid bartenders do not go on this form. See Schedule C.) |
| CG-SCHEDULE B | Worker Attachment | The schedule B form allows an organization to list those members who will assist in conducting their charity gaming activities. This form provides areas to list those who have been members of the organization for a minimum of 30 days. And allows space for the organization to list full time employees who are not members of the organization. |
| CG-Schedule B Mem | (coming soon) | |
| CG-Schedule B EMP | (coming soon) | |
| CG-SCHEDULE C | Bartender Attachment | The schedule C form will be used to list non-member paid bartenders to your annual activity license. (Members of the organization who meet the criteria for the Schedule A do not need to be repeated on this form if they are a paid bartend as well.) |
MISCELLANEOUS
| Form Identifier | Title | Use |
|---|---|---|
| CG-AM-AL | Annual License Amendment | To make changes to your Annual license, the license amendment request will be used. Make sure to include the Charity Gaming (CG) license number in box 4a and the Charity Gaming reference number in box 4b to identify the license you wish to make the change(s) to. |
| CG-AM SL | (coming soon) | For all other amendments not including the Annual please contact our office for further instructions |
| CG-CO | Current Officers |
(CG-OL – Officer List coming soon) Organizations must complete an officer listing when the officers change within the organization. This is necessary to determine who must sign the charity gaming forms. |
| CG-EXP | Expedited Application Request | We offer an expedited review process. Organizations may have their license application reviewed within 10 business days of receipt by completing this form and paying the expedited fee. (Please contact our office if you need assistance figuring the fee.) |
| CG-NPA | Non-Member Participation Approval | This form is used when an organization would like to borrow workers from another qualified organization to help assist as workers in their charity gaming activities. |
| CG-VTA | Volunteer Ticket Agent | There are times when an organization may wish to use non-members as workers. There are specific rules when using this form. A listing of these rules can be found on our website under the Helpful Information tab. |
| CG-SP | Special Permission Request | When conducting bingo, organizations are limited to an overall payout of $6,000 for the event. To increase this total overall payout for the bingo event, this is the form to use. |
FINANCIALS
| Form Identifier | Title | Use |
|---|---|---|
| CG-AL FGR | Annual License Financial Gross Receipts | Use for expiring Annual License. Each license issued requires financial reports. This financial gross receipts report will be used by organizations who have applied for and received an Annual Activity License for a 1-year period. (Replaces CG-AL FR and CG-AL GR) |
| CG-MY | Multi-Year Financial Gross Receipts | Use for Multi-Year Annual License as either 1st year anniversary, 2nd year anniversary or renewal report. This financial gross receipts report must be completed by those organizations who have applied for and received a “multi-year” license such as the Annual 3-Year Veterans license. (Replaces CG-AL FR and CG-AL GR) |
| CG-SL FR | Single Activity License Financial Report | When an organization holds either a Single Activity License, a Festival License or a Candidates Committee Raffle License, the CG-SL FR form is required to account for the income and certain expenses from that activity. |
| CG-SL GR | Single Activity Annual Gross Receipts Report | This form is used to determine the percentage of an organization’s charity gaming income with their other gross income. The CG-SL FR forms must be complete to complete this form. |
| CG-DIST | Charitable Contribution Distribution List | Donations to other organizations or entities can be reported using this form. This form is required if you have a figure listed box 34a on these forms: CG-AL FGR, CG-MY or CG-SL FR. |
| CG-INV | Ending Inventory Statement | While completing one of the financial reports listed above, you may need to also provide an ending inventory statement for those unsold pull tabs, punchboards and tip boards remaining in inventory. |
| CG-DTL | Inventory Destruction, Theft or Loss | If your organization has lost inventory either by way of pre-arranged destruction, theft or loss in some other manner, this form will need to be completed to account for the unsold inventory. |
| CG-ESR | Event Summary Report | After each activity, organizations are required to complete an event summary report for that day's charity gaming activities. |
| ESR-DWM | Raffle Board Daily Weekly Monthly Event Summary Report | This is another event summary report designed specifically for those organizations who conduct daily, weekly or monthly raffle drawings and/or use a raffle board. |
ANNUAL AFFILIATE (National Organization/National Foundation only)
| Form Identifier | Title | Use |
|---|---|---|
| CG-AAL | Application for Annual Affiliate License | |
| CG-AFF | Affiliation Attachment for Annual Affiliate License (AAL) Applicants | |
| CG-AAL FR | Annual Affiliate License Financial Report | |
| CG-AN | Affiliate Notification | |
| CG-AN ESR | Event Summary Report for Affiliate Notification | |
| CG-CO | Current Officers |
MANUFACTURER/DISTRIBUTOR
| Form Identifier | Title | Use |
|---|---|---|
| CG-MA/DA | Manufacturers and/or Distributors Indiana Gaming Card License Application | |
| CG-MDQ | Manufacturer and/or Distributor Quarterly Report | |
| CG-MDNF | Manufacturers and/or Distributor "Change of Ownership" Notification | |
| CG-MDA | Manufacturers and/or Distributor "Gaming Card License" Amendment Request |