FORM 50: Application for Renewal of National Lottery License

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FORM 50: Application for Renewal of National Lottery Licence
1. Name of applicant
2. Postal Address
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Physical Address
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Telephone
Fax

3. Details of licence being renewed:

Licence No.:
Date of Issue:
Place of Issue:
Date of Expiry:
4. Please provide any details of any changes to the operations of the business of the Applicant during the subsistence of the licence, i.e. change in employees, shareholders, directors, e.t.c.:more details
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DOCUMENTS TO BE SUBMITTED WITH THIS APPLICATION

1. Certified copy of certificate of incorporation or certificate of registration (if the Applicant is a company);
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2. Certified copies of share certificates (if the Applicant is a company);
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3. Proof of directorship (certified copies)(if the Applicant is a company) ;
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4. Tile deed, lease or sublease agreement of premises to be utilised for the operation of the National Lottery (certified copy);
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5. Copies of audited financial statements of the Applicant;
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6. Certified copy of tax clearance certificate of the Applicant;
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I certify that the information supplied on this application form (please print name clearly) is true and correct. I understand that failure to provide true and correct information will result in the failure of this application.
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