Horse-racing and Betting Ordinance, 1978 APPLICATION FOR REGISTRATION AS BOOKMAKER S MANAGER To the Gauteng Gambling Board, Private Bag X125, Centurion, 0046 PART A: (To be completed by applicant) 1 I,. (full name), Identity Number. do hereby, in terms of section 26 of the Horse-racing and Betting Ordinance, 1978 apply to be registered as a bookmaker s manager 2. This application is in respect of employment by (name of bookmaker) operating at. (name of Tattersalls). For the purpose of this application, I hereby furnish the following information which to the best of my knowledge and belief is true and correct: 1 Full residential address 2 Postal address.. 3 Telephone number (B). (H). 4 Date of birth 5 Nationality.. and identity number.. 6 I am the holder of a current bookmaker s licence No. Dated. /I am not the holder of a current bookmaker s licence* 7 I have/have not been convicted of an offence*, excluding an offence for which a caution and discharge was imposed or a sentence of only a fine not exceeding one hundred rand, with or without an alternative of imprisonment, was imposed. ORIGINAL LICENCE Page 1
8 If convicted of an offence contemplated in item 7 the nature and date thereof and the sentence imposed: 9 I have/have not been found guilty of a contravention of the clauses of the Constitution, rules or regulations of the Jockey Club of South Africa, a Tattersalls Committee, racing club or the Gauteng Gambling Board*. 10 If found guilty of a contravention contemplated in item 9 the nature and date thereof and the punishment imposed:.. 11 A bookmaker s licence of which I was the holder was cancelled or lapsed on The particulars of such licence and the circumstances of cancellation or lapsing being as follows:.. 12 I do/do not have any interest in horse-racing as owner, lessee or trainer of any race-horse*. 13 My interests as contemplated in item 12 are the following:. 14 My estate has/has not at any time been sequestrated*. 15 In respect of the sequestration contemplated in item 14, the following information is furnished: (a) My occupation at the time of my insolvency was (b) (c) The date of sequestration was. The date of my rehabilitation was.. * ORIGINAL LICENCE Page 2
16 Details of all my bank accounts are as follows: Bank Branch Account Number 17 I am a bookmaker member of.. Tattersalls/ I am not a bookmaker member of Tattersalls*. 18 My maximum liability at any time up to the expiry of the bookmaker s licence which may be issued to me pursuant to this application will be 19 I carry on the business of a licensed bookmaker as an individual/in partnership with whose business and residential address is/are as follows:..... 20 The following other persons will have an interest in my business as licensed bookmaker and full particulars of such persons are as follows:. 21 I furnish the following names and addresses of four business or professional references: 1 2 3 4 ORIGINAL LICENCE Page 3
22 Details of experience in the bookmaking business: 23 Current employer:... Position held: Number of years with current employer:.. 24 I understand that I will need the prior approval of the Gauteng Gambling Board for implementing any form of computerised record keeping. 25 I undertake to become a member of the Central Provinces Bookmakers Association within fourteen days of the granting of a bookmaker s licence to me and to submit proof of such membership to the Gauteng Gambling Board. 26 I hereby acknowledge that I am fully aware of the powers conferred upon an authorised officer of the Gauteng Gambling Board in terms of Section 41 of the Horse-racing and Betting Ordinance (Ordinance 24 of 1978). 27 I enclose the following in support of my application: (a) (b) (c) (d) Application fee of R50,00. Audited statement of assets and liabilities. Bank statements for the past six months. Notice of intention to apply for a bookmaker s licence published in newspapers circulating in the province. (e) Recommendation of my application by the Central Provinces Bookmakers Association.... Signature of Applicant. Date * Delete whichever is not applicable Note: Any person who furnishes any false or misleading information shall be guilty of an offence. ORIGINAL LICENCE Page 4
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