TRADE PROMOTION LOTTERY Lotteries and Art Unions Act, 1901 (Section 4B)

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1 PLEASE PRINT CLEARLY IN INK Department of Gaming and Racing Office of Charities Level 7, Cnr. Hay and Castlereagh Streets, Sydney NSW GPO Box 7060, Sydney NSW 2001 Phone No: (02) Fax. No: (02) Web site: A trade promotion lottery is a scheme to promote the products or services of a trade or business (a sole proprietor, a partnership or a body corporate) which offers prizes to winners determined on the outcome of a lottery or game of chance. Please note: 1. If more than one trade or business is to benefit from the trade promotion lottery, separate details as contained in Part 1 must be provided in respect of each trade or business. 2 Attach further information if space is insufficient. 3 The terms and conditions of entry into the trade promotion lottery, any electronic and/or print media advertising material and any entry forms, tickets, coupons, etc. must make provision for disclosing the permit number in the format Authorised under NSW Permit No TPL /. 4 This application cannot be processed until all parts are completed and the Permit No: Date Received: APPLICATION FOR A PERMIT TO CONDUCT A TRADE PROMOTION LOTTERY Lotteries and Art Unions Act, 1901 (Section 4B) PART 1. DETAILS OF TRADE OR BUSINESS 1.1 Contact person in trade or business: 1.2 Contact person's position in trade or business: 1.3 Trade or business name: 1.4 Trading name of trade or business (if applicable): 1.5 ABN number of trade or business (if applicable): Amount: Receipt No: Examined: Approved: relevant documents supplied as requested. Failure to provide the required information may result in refusal of the application. 5 Under section 17A of the Lotteries and Art Unions Act it is an offence to provide false or misleading information in a material particular in an application or notice given under the Act. Penalty: Maximum fine of up to $5,500 or imprisonment, or both. In addition, providing false or misleading information may result in cancellation or suspension of any permit granted. 6 The permit will be granted in the name of the trade or business the sole proprietor, the partners in a partnership or the body corporate. The sole proprietor, the partners in the partnership, or the directors of the body corporate will be severally liable for the proper conduct of the trade promotion lottery, as the holder of the permit. 7. If you require a permit to cover all lotteries during a specific period refer to Check List Item 7.21 for more information. Title First name/s Family name / Surname Name of sole proprietor, names of all partners in a partnership, name of body corporate 1.6 Business address: No. Street name Suburb / town / city Post code 1.7 Postal address: No. Street name / PO box Suburb / town / city Post code 1.8 Contact details: Work phone no. Mobile phone no. Fax. no. No. 1.9 Description of products and services conducted / provided by trade or business: 1.10 Title or name by which trade promotional lottery is to be known: 1.11 If the trade promotion lottery is to be promoted on the Internet, please enter the web page URL: and A NEW SOUTH WALES GOVERNMENT DEPARTMENT OFFICE USE ONLY PART 2. DETAILS OF PRIZES The terms and conditions of entry into the trade promotion lottery must provide a clear and unambiguous description of the prizes. The following prizes are prohibited: tobacco products, cosmetic surgery; weapons, fi rearms and ammunition. Refer Check List Part 7.9 ~ Tick all prize category boxes that apply. In respect of the checked categories (except "other") certain particulars must be included in any advertisement, notice or information and in some cases certain information must be provided with the application. Refer Check List - Part 7. Number in brackets refers to check list item. Travel prizes (7.3) Motor vehicle (7.4) Machinery, electrical prizes (7.5) Real estate prizes (7.6) Liquor prizes (7.7) Cash prizes (7.8) Other trade_promotion_lottery_application_l June Attach to this application a list showing full particulars of the prize(s) to be awarded in conjunction with the trade promotion lottery. The list must contain information similar to the following table. PRIZE DESCRIPTION Refer Trade Promotion Lottery Fact Sheet for more details. QUANTITY RETAIL VALUE OF EACH PRIZE $ T OTAL VALUE OF PRIZES IN NSW $ Note: The total value of the prizes to be awarded in NSW determines the fee payable. Where the trade promotion lottery is to be conducted nationally, the total value of prizes in NSW is the total value of prizes for the trade promotion lottery, except where there are specifi c prizes for each State and Territory. Refer Part Total value of prizes in NSW... $ 2.4 Total number of individual prizes Total number of individual prizes over $10, Number of draws with total value of prizes over $10, TOTAL VALUE $

2 PART 3. DETAILS OF ENTRY 3.1 Attach the following documents to this application: A copy of the proposed entry form, ticket, coupon (if any) A copy of any proposed advertising, notice or information that will be communicated to prospective participants. Refer Check List Part 7.2. This includes newspaper/magazine advertising, radio/ television advertising copy, direct mail letters and web site pages. A copy of the proposed terms and conditions of entry that will be communicated to prospective participants. The terms and conditions of entry must include the method by which persons enter and how the winners are decided. Refer Check List Part Please tick the method(s) of entry which apply to this trade promotion lottery. Entry form required to be completed Proof of purchase required (ie. receipt, label, bottle cap, bar code) Entry available by entry box / barrel Entry available by mail Entry available by fax Entry available by telephone call Entry available by 1900-telephone Entry available on Internet Entry automatically recorded by purchase / subscription Pre-determined, instant win, scratch, break-open or bingo-style competition Other (please provide details) 3.3 Does entry into the trade promotion lottery involve the following attributes? Please tick one or more. Attach to this application the additional particulars sought in Check List Part 7. Numbers in brackets refers to check list item telephone number facility (7.12) Computerised and similar systems to determine winners (7.13) Pre-determined, instant, scratch, break-open or bingo-style (7.14) Gaming machines (7.15) NSW Lotteries products (7.16) Charities and not-for-profi t organisations (7.17) Olympics or Olympic theme (7.18) Winners decided on the outcome of a horse or greyhound race (7.19) Card jackpot games (7.20) 3.4 Estimate of the number of tickets, entry forms, coupons, etc. (if any) it is proposed to distribute. 3.5 Start and finish dates Start (commencement) date* Finish (closing) date**... A permit will be issued for the period requested up to a maximum of 12 months (or 15 months, if second chance draw is necessary). A permit may be issued for a longer period under exceptional circumstances. * Show date on which the competition will be fi rst advertised or on which entry forms, etc. will be fi rst issued, whichever is the lesser. ** Show the date on which the winner will be announced/published (this would be the date after the conduct of the fi nal draw or the second chance draw). PLEASE PRINT CLEARLY IN INK PART 4. DETAILS OF DRAW 4.1 Prizewinner selection. Please tick the method(s) of selecting winning entries which apply to this trade promotion lottery. Barrel draw Spinning wheel Nominated caller Computer-generated selection Random selection of 1900-telephone calls Single draw for one prize Single draw for all prizes Minor prize draws prior to draw for major prize(s) Minor prize draws only: daily weekly monthly quarterly other Pre-determined, instant, scratch, break-open or bingo-style Other methods that apply to the selection of winners. Please provide details: 4.3 Date(s) of draw(s) Prize draw(s) conducted at the following time(s) and date(s)/day(s): Eg pm on 21 July Eg pm on 1 July 2001, 5 August 2001, 2 September 2001, and draw for major prize on 7 October Eg pm, 6.30pm and 7.00pm every Friday. Eg pm 3rd Monday of each month. 4.4 Place of draw(s): THE DRAW MUST BE CONDUCTED IN NSW Place of draw (NSW ONLY): Street no. Name of premises and fl oor number (if applicable) Street name (NSW ONLY) 4.2 Scrutiny of the draw (refer note below right) In any draw where the total value of the prizes is over $10,000, the draw and the announcement of the winner(s) must be scrutinised by an independent person unless the Department has otherwise granted approval. The independent person is not to be involved with the management, conduct or promotion of the trade promotion lottery, and is not to be a director, partner, employee or otherwise employed by, or under contract to, the business or trade, the promoter, or an associated trade or business. The independent person is required to submit a report to the Department following the draw. Refer to the Trade Promotion Lottery Fact Sheet for more information. Tick one box only. An independent person will scrutinise the draw(s) and submit a report in accordance with requirements. A request for approval for a non-independent person to scrutinise the draw(s) is attached. These requirements do not apply because in any draw the total value of the prizes is $10,000 or less. These requirements do not apply because the winners are solely decided through a pre-determined, instant win, scratch, break-open or bingo-style lottery or game of chance (Refer Check List item 7.14). A request for exemption from the need to comply with this requirement is attached. I am of the opinion that the nature of the draw system or process makes this scrutiny requirement unduly onerous (approval will be granted in exceptional circumstances only). Suburb / town / city (NSW ONLY) Post code (NSW ONLY) 4.5 Date winners announced Provide specifi c date(s)/day(s) in all cases, and time(s), if applicable. The last date shown should be the same as the fi nish date (refer 3.5.2) unless a second chance draw is conducted. Eg.1-21 October Eg pm on day of draw. 4.6 Method of notifying winner(s) and other persons of the result Eg. public address (PA) announcement; posting of notifi cation on notice board; personal notifi cation by mail; public notices of 'newspaper'. Scrutiny of draw note (refer 4.2): (1) If the trade promotion lottery involves winners being determined through a pre-determined, instant win, scratch, break-open or bingo-style lottery or game of chance, but the winners of major prizes are determined by a normal draw these scrutiny requirements apply. (2) If a second chance draw is required these scrutiny requirements apply.

3 PART 5. APPLICATION FOR PERMIT This part is to be completed by the sole proprietor, a partner in a partnership, or a director of or authorised person within a body corporate (company) of the trade or business, or any other person so authorised in writing on behalf of the trade or business, herein after referred to as the applicant. By lodging this application for a permit to conduct the lottery or game of chance for the promotion of trade described in this application, the applicant: (a) declares that he/she is duly authorised in writing to make the application on behalf of the trade or business (a copy is held by the applicant), (b) declares that the contents of this application including any documents accompanying the application are true and correct, and (c) declares that he/she is 18 years or older. 5.1 Name of applicant: Title First name/s Family name / Surname 5.2 Position held with employer: 5.3 Employer name: Name of sole proprietor, names of all partners in a partnership, name of body corporate (company) 5.4 Trading name of employer (if applicable): 5.5 ABN Number of employer (if applicable): 5.6 Business address: No. Street name Suburb / town / city Postcode 5.7 Postal address: No. Street name / PO box Suburb / town / city Postcode 5.8 Contact details: Work phone no. Mobile phone no. Fax. no. no. PLEASE PRINT CLEARLY IN INK Signature Date If a permit under section 4B of the Act is granted to allow the conduct of a lottery or game of chance for the promotion of trade or business (trade promotion lottery), the permit will be granted in the name of the trade or business, that is in the name of the sole proprietor, the names of the partners in a partnership or the name of the body corporate. The sole proprietor, the partners in the partnership, or the directors of the body corporate will be severally liable for the proper conduct of the trade promotion lottery in accordance with the information contained in or accompanying this application, the provisions of the Lotteries and Art Unions Act, the regulations under the Act, and the conditions attached to the permit authorising the conduct of the trade promotion lottery. If a permit under section 4B of the Act is granted, a permit condition requires any electronic and print media advertising material and entry forms to disclose the permit number in the format Authorised under NSW Permit No TPL /. Failure to disclose the permit number will result in the lottery or game of chance being unlawful under section 3 of the Act. By disclosing the permit number it is taken that the sole proprietor, the partners in the partnership or the body corporate has made application for the permit, and having received the authorising permit accepted the obligation to conduct the lottery or game of chance in accordance with the information contained in or accompanying this application, the provisions of the Lotteries and Art Unions Act, the regulations under the Act, and the conditions attached to the permit authorising the conduct of the trade promotion lottery. Under section 17A of the Lotteries and Art Unions Act it is an offence to provide false or misleading information in a material particular in an application or notice given under the Act. Penalty: Maximum fine of up to $5,500 or imprisonment, or both. In addition, providing false or misleading information may result in cancellation or suspension of any permit granted. Failure to provide required information may result in refusal of the application. PART 6. PAYMENT DETAILS (1) The application must be accompanied by the application fee. See table below. The total value of the prizes to be awarded in NSW determines the fee payable. Where the trade promotion lottery is to be conducted nationally, the total value of prizes in NSW is the total value of prizes for the trade promotion lottery, except where there are specific prizes for States and Territories. (2) Payment is to be made by cheque or money order. Please make cheque or money order payable to the Department of Gaming and Racing. Money may be used to pay for applications presented in person only. There is no facility for payment by credit card transaction or electronic transfer of funds unless the application is lodged electronically via the Department's Internet web site Total value of prizes in NSW (same as 2.3).. $ 6.2 Application fee payable:... $ P rize Value $ Fee $ under 10, ,001-50, , , , ,000 1,000 over 200,000 2,000 What to do next: Complete the Check List (Part 7) and lodge the completed form with the Department of Gaming and Racing Postal: GPO Box 7060, Sydney NSW 2001 Business: Level 7, Cnr. Hay and Castlereagh Streets, Sydney NSW Phone No: (02) Fax. No: (02) lottery.inquiries@dgr.nsw.gov.au Web site:

4 PART 7. CHECK LIST Refer to the Trade Promotion Lottery Fact Sheet for more information. 7.1 Entry is free The proposed trade promotion lottery does not involve the payment of any entry fees or charges. A lottery in which entry is gained by the purchase of goods or services (eg. where proof of purchase is required) does not normally breach the requirement that entry must be free. 7.2 Attachments If there was insufficient room on the application to provide a written answer, I have made a note against the question on the application which refers to a particular named document which is attached to the application to provide an answer to the question. (Refer 4.2) If I am required to have a person scrutinise the draw, and if I have decided that the circumstances warrant, I have attached a request for: approval for a non-independent person to scrutinise the draw OR approval for exemption from the need to comply with this requirement. The following documents have been supplied to support the application: a copy of the proposed entry form, ticket, coupon (if any) a copy of the proposed terms and conditions of entry that will be communicated to prospective participants a copy of any proposed advertising or promotional material which will be communicated to prospective participants. This includes newspaper / magazine advertising, radio / television copy, direct mail letters, and a print of Internet web site pages if I have not provided the information elsewhere, I have provided an attachment which lists the full particulars of the prize(s) to be awarded in conjunction with the proposed lottery. This list contains the following categories in table format: prize description, quantity, retail value of each prize and the total value of all prizes. 7.3 Travel prizes The proposed trade promotion lottery does not involve travel prizes, OR if it does, I have checked the following particulars. valuation number of people able to take the travel prize destination class of air fare (first, business or economy class) level of accommodation (eg. four star and name, location of hotel) whether meals are included whether transfers are included whether other transport is included whether spending money is included restrictions including duration of travel prize, when travel prize must be taken (validity, non-peak periods, availability) whether redeemable for cash. 7.4 Motor vehicle prizes The proposed trade promotion lottery does not involve a motor vehicle, OR if it does, I have checked the following particulars. valuation make model accessories whether registration, on-road costs included restrictions whether redeemable for cash. 7.5 Machinery and electrical appliance prizes The proposed trade promotion lottery does not involve machinery or electrical prizes, OR if it does, I have checked the following particulars. valuation make model accessories restrictions whether redeemable for cash. 7.6 Real estate prizes The proposed trade promotion lottery does not involve real estate prizes, OR if it does, I have checked the following particulars. valuation type of dwelling location (lot number etc) what is included (eg. conveyancing and legal costs, furniture) restrictions whether redeemable for cash. valuation certificate plans contract details easement details. 7.7 Liquor prizes The proposed trade promotion lottery does not involve liquor prizes, OR if it does, the maximum quantity offered as a prize, or all prizes in the lottery, does not exceed 20 litres. 7.8 Cash / money prizes The proposed trade promotion lottery does not involve cash prizes, OR if it does, I have checked the following particulars. There is no single cash prize which exceeds $100,000. The total value of cash prizes does exceed $400,000 in any 4 week period. In calculating cash prizes besides bank drafts, cheques and any other order, warrant, authority or request for the payment of money I have included the value of shares, annuities, policies of insurance, bonds, investment portfolios, bullion and similar instruments as cash. 7.9 Tobacco product prizes The lottery does not involve tobacco products in any form as prizes Cosmetic surgery prizes The lottery does not involve cosmetic surgery as prizes. "Cosmetic surgery" is any procedure performed to reshape normal structures of the body, or to adorn parts of the body with the aim of improving the consumer's appearance and self-esteem Weapons, firearms and ammunition prizes The lottery does not involve weapons, firearms or ammunition as prizes telephone number facilities The proposed trade promotion lottery does not involve a 1900-telephone number facility, OR if it does, I have checked the following particulars. I have completed Check List Item 7.13 (Computerised and similar systems). The 1900-telephone facility is not linked to the provision of further information which may involve details of the terms and conditions of entry into the lottery; the provision of numbers or symbols which a person marksoff or scratches-off a game card or otherwise matches with other numbers or symbols hidden or displayed on a game card or other publication. the 1900-telephone number(s) to be used the name of the 1900-telephone number service provider a written undertaking which says that the call cost to a participant using the 1900-telephone facility will not exceed 50 cents plus GST the 1900-telephone number script, advertising copy, and the terms and conditions of entry clearly state that the call cost will not exceed 50 cents plus GST. The message on the 1900-telephone number is only sufficient to identify the lottery, to seek a short responses that would for example ensure that the participant has purchased or has knowledge of a certain product of service, and to enable the participant to leave a short message of their name, address and/or telephone number Computerised and similar systems including 1900-telephone facilities The proposed trade promotion lottery does not involve a computerised or similar system, OR if it does, I have checked the following particulars (refer Integrity Provisions of the Trade Promotion Lotteries Fact Sheet). The computerised or similar system has been previously approved by the Department and I have attached a copy of that approval notice. The draw procedure using the computerised or similar system has been previously approved by the Department and I have attached a copy of that approval notice. The computerised or similar system has been previously approved, but I do not have a copy of the Department s approval notice, I have: advised the name of the device, and the name of the manufacturer provided a Draw Procedure Report. The computerised or similar system has not been previously approved by the Department and I have provided: an Appraisal Report which includes the name, title, address and details of the expertise of the person giving the appraisal report (the appraisal report must be sourced from an independent person with knowledge of computerised devices and programs refer to page 6 of the Trade Promotion Lotteries Fact Sheet for more information), the name and address of the supplier, manufacturer or developer of the device or system, name and model number of the random number generating

5 PART 7. CHECK LIST Refer to the Trade Promotion Lottery Fact Sheet for more information. device or name of the application or software of the computerised random number generator, a description of the device or system including control and security features (access, passwords), operating procedures, whether system is tamper-proof and all entrants have a equal chance of winning, technical data and promotional material, and whether the system provides a hard-copy of the prizewinners. a Draw Procedure Report which provides the purposes for which the device will be used, the procedures used in entering the range of numbers or the draw procedure, the safeguards and controls exercised over the draw process (accessibility, passwords, supervision), how the results are to be announced, and what precautions are taken to ensure there is no substitution of prizewinners Pre-determined, instant win, scratch, break-open, or bingostyle trade promotion lotteries The proposed trade promotion lottery does not involve a pre-determined, instant win, scratch, break-open, or bingo-style methods, OR if it does, I have checked the following particulars. The game material is not promoted in such a way which may mislead the public into thinking that the lottery is a NSW Government licensed lottery or game of chance product. A provision has been included in the terms and conditions of entry: that any unclaimed prizes from the advertised prize pool will be distributed describing how the unclaimed prizes will be distributed that at the end of the lottery all claims for prizes and entitlements to claims will be met notwithstanding the advertised prize pool has been exceeded that printing er rors or other quality con trol mat ters outside the control of the individual player shall not be used as the sole basis for refusing to award a prize in respect of random games (games where the number of possible winners is not known beforehand being the result of chance or lot), where there is more than one claim for a particular prize of $5,000 or less, each claimant is to receive an equal share of the prize or $1,000 whichever is the greater, and where there is more than one claim for a particular prize of over $5,000, each claimant is to receive an equal share of the prize, or 10% of the prize or $2,000, whichever is the greater in respect of controlled games (games where the number of possible winners is known beforehand, based on the number of winning game material printed) the sharing of prizes is not permitted. In any advertising, notice or information: where the value of prizes is high, the words TOTAL PRIZE POOL is included in a prominent manner against the prize pool value where possible, the game material (comprising tickets or cards) displays the maximum number of game material to be distributed the terms and conditions of entry the total prize structure or where this is not possible, this information will be otherwise provided to participants. name and address of the person responsible for preparing and printing the game material how and by whom the winning num bers or symbols are to be determined how and by whom the winning game material is to be distributed the full prize structure to be won over the period of the lottery esti mat ed prize payouts (if appro pri ate) for each week of the lottery a written assurance that the system cannot be tampered with in any way by any per son or organisation in volved in the produc tion or distribution of the game material. It is understood that: all details of claims for prizes over $100 which are denied will be retained and that these details will include the name and address of each claimant and the reason(s) why each claim was not met claimants will be informed as soon as possible of the reasons for refusing to award a prize, unless forgery or similar tampering with the game material is suspected and the reason for the refusal of the prize cannot be given because of possible legal consequences. a condition may be imposed that following the completion of the lottery, the conduct of the lottery is to be audited by a professionally qualified person, who is independent of the trade or business. Following the examination the auditor is to form an opinion: whether the lottery was conducted in such a manner as to give every person who entered a fair and equal chance of winning whether the security controls were in place, and whether the permit conditions, the terms and conditions of entry into the lottery and the provisions of the Act were complied with Gaming machines The proposed trade promotion lottery does not involve gaming machines, OR if it does, the terms and conditions of entry provides information about the basis upon which entry is gained by playing the gaming machine eg. based on every $100 of turnover NSW Government licensed lottery products The manner in which the trade promotion lottery is to be conducted, promoted or advertised is not similar to a NSW Government licensed lottery or game of chance product (eg. Lotto, Scratch lotteries, Keno). If the proposed trade promotion lottery uses a NSW Government licensed lottery or game of chance product in conjunction with its conduct, other than as a prize, I have sought and obtained the agreement of the licensee (eg. NSW Lotteries) and lodged a copy of that agreement with the application Charities and not-for-profit organisations The manner in which the trade promotion lottery is to be conducted, promoted or advertised does not state or imply that the lottery is to be conducted in conjunction with a charity or a charitable purpose or a not-for-profit organisation, OR if it does, I have sought and obtained the agreement of the charity or the not-for-profit organisation and lodged a copy of this agreement with the application, and I have attached to the application a statement giving assurance that the proceeds of the fundraising appeal will not be used to fund the conduct of, or the prizes in, the lottery, and an assurance that the proceeds will be banked intact into the account of the benefiting organisation Olympics or Olympic theme The manner in which the trade promotion lottery is to be conducted, promoted or advertised does not state or imply that the lottery is to be conducted in conjunction with the Olympics or an Olympic theme, OR if it does, I have sought and obtained the agreement of the Australian Olympic Committee and lodged a copy of this agreement with the application Winner decided on outcome of horse or greyhound race The manner in which the trade promotion lottery is to be conducted, promoted or advertised does not state or imply that the lottery is to be conducted on the basis that winners will be determined on the basis of forecasting a future horse or greyhound racing event, OR if it does, I have included with the application evidence that the trade promotion lottery will only benefit a race club and is conducted at a racecourse in conjunction with a race meeting Card jackpot games (for more information refer to the Card Jackpot Games Fact Sheet and accompanying Guidelines) The proposed trade promotion lottery does not involve a card jackpot game, OR if it does, I have checked the following particulars. The application is accompanied by: terms and conditions of entry (refer to document labelled A in the Guidelines) if conducted in conjunction with a fundraising raffle: the raffle terms and conditions of entry (refer to document labelled B in the Guidelines) the declaration (refer to document labelled C in the Guidelines) the terms and conditions that you intend to display to patrons (can be same as above) Permit to conduct all lotteries during a specific period (refer to the Trade Promotion Lotteries Fact Sheet for more information) The proposed trade promotion lottery does not involve a request for a permit to cover all lotteries during a specific period, OR if it does, I have checked the following particulars. The name or title of the lottery is shown as All lotteries and games of chance. The application is accompanied by: an outline of the types of contests, promotions, giveaways, etc, planned or intended to be conducted a general description of the types of prizes to be awarded and their approximate value the processing fee of $250 for a prize pool that does not exceed $50,000 or $500 for a prize pool that does not exceed $100,000.