Small Society Lotteries
Application Form for Registration of Non-Commercial
Society under Schedule 11 of the Gambling Act 2005
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1. Society lotteries are lotteries promoted for the
benefit of a non-commercial society. A society can
be considered non-commercial if it is established
and conducted for:
Charitable purposes.
The purpose of enabling participation in, or
of supporting, sport, athletics or a cultural
Any other non-commercial purpose other than
that of private gain.
2. A lottery is defined as small under the Act if
ticket sales are no more than £20,000 and where
the society’s aggregate proceeds do not exceed
£250,000 a year.
3. If you are completing this application form by
hand please write legibly in BLOCK CAPITALS and
write in BLACK INK.
4. In order to accept an application for society lottery
registration the Licensing Team must be satisfied
that your society is a properly constituted society
that is raising monies for charitable / benevolent
purposes. With this in mind if you have to hand a
copy of the terms and conditions of the society’s
constitution (including details on how you intend
to decide on the dispersal of funds and publicise
the said dispersal) you asked to include the same
with your application for registration.
5. The Licensing Authority will notify you of any error
or omission in the application for registration. If
you fail to rectify any error the Licensing Authority
may refuse your application.
6. The completed application must be returned to:
The Licensing Team, East Lindsey District Council,
Tedder Hall, Manby Park, LOUTH, Lincs, LN11 8UP.
7. Please ensure that you complete the appointment
of counter signatories form attached to the rear of
this application form.
8. The application fee of £40.00 must be paid with
this application. Cheques and postal orders should
be made payable to East Lindsey District Council.
Please note that we no longer accept cash for the
payment of licence application fees.
The Licensing Team is able to provide facilities
for licence payments by credit or debit cards.
Further information is available by contacting the
Licensing Team direct.
9. Conditions of application:
Your society must be non-commercial.
At least 20% of the lottery proceeds must be
applied to the purposes of the society.
No single prize may be worth more £25,000.
Every ticket in the lottery must cost the same
and must be paid for before entry into the
draw is allowed.
After each lottery a society must submit a
‘return’ to the Council no later than three
months after the draw took place.
10. The society must appoint adult members of the
society to certify the lottery returns, which must
be submitted to the Licensing Authority. See page
6 of this form.
11. You must be registered with the local Authority in
the area where the principal office of the society is
Please read the following instructions
and any guidance leaflet enclosed before
completing this application form.
(Form last revised March 2018)
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Gambling Act 2005
Application Form for Registration of Non-Commercial Society
SECTION A – Details of society applying for registration
1. Name of society
2. Address (including postcode) of office or head office of society
3. Telephone number of society and email address
4. Please state the purpose(s) for which the society is established and conducted
5. If the society is a registered charity, please give the society’s unique charity registration number
6. Has the society held an operating licence under the Gambling Act 2005 in the period of five years ending
with the date of this application? Yes No
7. If the answer to question 6 is ‘Yes’, has the operating licence been revoked in the period of five years ending
with the date of this application? Yes No
8. If the answer to question 7 is ‘Yes’, please state the reasons for revocation and enclose a copy of the notice of
revocation if one is available
If you are completing this form by hand, please write legibly in block capitals using ink.
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9. Has the society applied for and been refused an operating licence in the period of five year sending with the
date of this application? Yes No
SECTION B – General information about person applying on behalf of society
10. Full Name (including Mr, Mrs, Miss or Ms)
11. Capacity (e.g. secretary, treasurer, promoter)
12. Address (including postcode)
13. Daytime telephone number and email address
SECTION C – Contact details for correspondence associated with this application
14. Please tick one box as appropriate to indicate address for correspondence in relation to this application:
Address in section A Address in section B Address below
Address (including postcode)
Telephone number
Email address (if the applicant is happy for correspondence in relation to this
application to be sent via e-mail)
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SECTION D – Declaration
15. Please complete the following declaration and checklist:
I [Full Name]
a. make this application on behalf of the society referred to in Section A and have
authority to act on behalf of that society.
b. enclose payment of the registration fee of £40.
(Please make all payments payable to East Lindsey District Council (ELDC))
c. confirm that, to the best of my knowledge, the information contained in this application is true. I
understand that it is an offence under section 342 of the Gambling Act 2005 to give information which
is false or misleading in, or in relation to, this application.
Your information will be processed in accordance with the law, in particular the Data Protection Act 1998 and
the Freedom of Information Act 2000. The information that you provide will only be used for Council purposes
unless there is a legal authority to do otherwise.
This Authority is under a duty to protect the public funds it administers, and to this end may use the
information you have provided on this form for the prevention and detection of fraud. It may also share this
information with other bodies responsible for auditing or administering public funds for these purposes. For
further information contact the Licensing Team.
Note to societies applying for registration:
The application will be refused if in the period of five years ending with the date of the application:
an operating licence held by the society has been revoked under section 119(1) of the Gambling Act 2005, or
(b) an application for an operating licence made by the society has been refused.
The application may be refused if the local authority think that:
(a) the society is not a non-commercial society,
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(b) a person who will or may be connected with the promotion of the lottery has been convicted of a
relevant offence, or
(c) information provided in or with the application is false or misleading.
Payment Rec’d:
Licensing Team
East Lindsey District Council
Tedder Hall
Manby Park
LN11 8UP
Contact Details:
Tel: 01507 601111
Please ensure that you complete the Appointment of Countersignatories form shown overleaf.
Gambling Act 2005, Schedule 11
Appointment of Counter Signatories in Respect Society Lottery Returns.
Name of Society:
Address of Society (including postcode):
Paragraph 39 of Schedule 11 to the Gambling Act 2005 requires all societies registered with the Local Authority to
appoint adult members of the society to certify lottery returns.
The following persons are hereby appointed by the above society to certify lottery returns submitted to East
Lindsey District Council:
Full Name of Counter Signatory: (including Mr, Mrs, Miss or Ms)
Address (including postcode):
Signature: Date:
Full Name of Counter Signatory: (including Mr, Mrs, Miss or Ms)
Address (including postcode):
Signature: Date:
Name of Person Certifying the Appointment:
(This should be the person shown in Section B of this form)
Position within the Society:
Signature: Date:
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Data Protection Notice – Small Society Lottery Registration
East Lindsey District Council is a Data Controller and can be contacted at:
Tedder Hall, Manby Park, Louth, Lincolnshire, LN11 8UP
Tel: 01507 601111
The Data Protection Officer for this Authority can be contacted at the same address.
We are collecting your personal data in order to process your application under Licensing Legislation as we are the
Licensing Authority.
Your data will not be shared with third parties but may be used for Council purposes, in order to prevent or detect
crime, to protect public funds or where we are required or permitted to share data under other legislation.
In line with our retention policy your data will be kept for the period of time that you hold a registration with this
Authority and then for a further 6 years after your registration expires. The data will then be deleted / destroyed at
the end of the aforementioned 6 year period.
You have the right to access your data and to rectify mistakes, erase, restrict, object or move your data in certain
circumstances. Please contact the Data Protection Officer for further information or go to our website where
your rights are explained in more detail. If you would like to receive an explanation of your rights in paper format
please contact the Data Protection Officer.
Any complaints regarding your data should be addressed to the Data Protection Officer in the first instance. If the
matter is not resolved you can contact the Information Commissioner’s Office at:
Wycliffe House, Water Lane, Wilmslow, Cheshire, SK9 5AF
Tel: 0303 123 1113
If you do not provide the information required on the form then we will not be able to process your application for
For further information on our Data Protection Policies please go to our website:
The Licensing Team, East Lindsey District Council, Tedder Hall,
Manby Park, Louth LN11 8UP Telephone 01507 601111