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Back to Revised Laws of Saint Lucia (2023)

PART D
GENERAL REQUIREMENTS AND DECLARATION

43.	Attach references from 3 persons who are well known to you, but to whom you are not related. (The referees must be responsible persons, preferably members of a recognised professional body; they must state the length of time for which they have known you).
44.	Attach 2 copies of a recent black and white photograph, passport size. Each copy must be signed and dated by a responsible person who can confirm your identity and certify the likeness of the photographs (the signatory may be one of your referees).
45.	Attach a full set of fingerprints taken at a Police Station or by a reputable agency, and certified accordingly (fingerprints from both hands are required).
46.	Have you listed all of your assets and liabilities in paragraph 39 and 40 respectively? (state YES or NO) ...
	I certify that to the best of my knowledge and belief, the information given in this declaration is correct.
DATE ...................................		SIGNED .............................................
		Witness ..............................................
		Address of Witness ________________
		____________________________

FORM IB
(Regulation 3)
STATEMENT OF ASSETS AND LIABILITIES
(Gaming Control Act: Section 16)
NAME:
Cash in Hand
Cash in bank
Accounts receivable
Stocks & Bonds – Private Companies
Others
Real Estate
Pension Funds
Furniture etc.
Vehicles
Other Assets	_________________________
Total Assets	_________________________
Notes Payable
Accounts Payable
Mortgages
Other Liabilities	_________________________
Total Liabilities	_________________________
Net Worth	_________________________

ANNEXES TO STATEMENT OF ASSETS AND LIABILITIES
A.			CASH IN BANK
			List all bank accounts, both domestic and foreign, maintained by you, and disclose the following details—
(i)							Name and address of bank
(ii)							Name of person appearing on account
(iii)							Account number
(iv)							Interest rate (%)
(v)							General nature of account
(vi)							Balance as at
			Copies of account statements should also be provided to substantiate balances as at
B.			ACCOUNTS RECEIVABLE
			List all accounts receivable by you.
			The following details should be disclosed—
(i)							Name and address of debtor
(ii)							Interest rate
(iii)							Original amount due
(iv)							Date due
(v)							Amount incurred
(vi)							Amount recorded per books
(vii)							Current market value
C.		STOCKS AND BONDS
		List all stocks and bonds held or controlled by you. Wherever an interest exists through a beneficial interest in a trust, the stocks and bonds held in that trust should be listed. Publicly traded stocks and bonds should be indicated by an asterisk.
		The following details should be disclosed—
(i)						Name of company or Government Agency issuing
(ii)						Number held
(iii)						Type of Stock/Bond held
(iv)						Purchase price
(v)						Market Value as
(vi)						Percentage of ownership
(vii)						Name in which held
(viii)						Date of purchase
D.	REALESTATE
	List any real estate property in which any direct, indirect, vested or contingent interest is held by you.
	The following details should be disclosed—
(i)						Location
(ii)						Size
(iii)						General nature
(iv)						Date acquired
(v)						Individuals or entities sharing interest
(vi)						Purchase price
(vii)						Current market Value
			Any formal valuations should detail the date of valuation and the name and qualification of the valuer.
E.			PENSION FUNDS
			List the cash value of all pension funds held by you.
			The following details should be disclosed—
(i)						Employer
(ii)						Employee distribution
(iii)						Employer contribution
(iv)						Cash value as at
Similar details should be provided of personal pension plans.
F.			FURNITURE ETC.
			List any furniture or chattels having an individual current market value of $50,000 or more held by you.
			The following details should be disclosed—
(i)					Description
(ii)					Date acquired
(iii)					Individuals or entities sharing interest
(iv)					Purchase price
(v)					Current market value
Any formal valuations should detail the date of valuation and the name and qualifications of the valuer.
G.			VEHICLES
			List all vehicles owned by you.
			The following details should be disclosed—
(i)						Type of vehicle
(ii)						Date of purchase
(iii)						Year of vehicle
(iv)						Make/model of vehicle
(v)						Cost
(vi)						Current market value
H.			OTHER ASSETS
			List any other assets with an individual value of $50,000 or more held by you.
			The following details should be disclosed—
(i)						Description
(ii)						Date acquired
(iii)						Individual
(iv)						Purchase price
(v)						Current market value
			Any formal valuations should detail the date of valuation and the name and qualifications of the valuer.
I.			NOTES PAYABLE
			List all notes payable for which you are obligated.
			The following details should be disclosed—
(i)						Name and address of creditor
(ii)						Date incurred
(iii)						Termination date
(iv)						Outstanding liability at
(v)						Nature of security, if any
(vi)						Purpose of loan
J.			ACCOUNTS PAYABLE
			List all accounts payable, with an outstanding liability of $10,000 or more at _________________ for which you are obligated.
			The following details should be disclosed—
(i)						Name and address of creditor
(ii)						Date incurred
(iii)						Date due
(iv)						Original liability
(v)						Outstanding liability at
K.			MORTGAGES
			List all mortgages or liens payable on property for which you are obligated.
			The following details should be provided—
(i)						Name and address of creditor
(ii)						Nature of mortgage of lien
(iii)						Description/address of property
(iv)						Term of mortgage/interest rate
(v)						Amount of periodic payment
(vi)						Original amount of liability
(vii)						Outstanding liability at
L.			OTHER LIABILITIES
				List any other liabilities with an individual value of $10,000 or more for which you are obligated.
				The following details should be provided—
(i)						Name and address of creditor
(ii)						Date incurred
(iii)						Date due
(iv)						Original liability
(v)						Outstanding liability at

SAINT LUCIA
FORM 1C
(Regulation 3)
AUTHORISATION FOR INFORMATION
(Gaming Control Act: Section 16)
Name ___________________
Address: __________________
1.	I, ___________________________ have made application to the Board of the
[insert name of applicant]
Gaming Authority for a _______________________________________, and I
[insert name of licence]
	hereby give my authorisation to any and all persons or organisations, to include police or banks, for the release of any information regarding me, whether of written record or otherwise, to the Inspector of the Board of the Gaming Authority on request.
2.	In connection with my application, I will not hold any person or organisation responsible in any way for the information which they furnish relative to me, whether such information is oral or written. Further, I will not hold any person or organisation liable for any publicity which may arise out of my application to the Board of the Gaming Authority.
3.	Date .....................................................................................................
Signed .........................................
Witness .......................................
Address .......................................

FORM 2

(Regulation 4)

NOTICE OF MAKING APPLICATION

(Gaming Control Act: Section 17)

The public is hereby notified that ______________________________________

[Name of applicant]

has applied for a licence under section 16 of the Gaming Control Act.

A person who desires to object to the grant of the licence shall, not later than

_________________________________________________________,

[date not less than 14 days from date of publication]

submit to the Secretary to the Board of the Gaming Authority a statement in writing of the reason for his or her objections.

Dated this ________ day of ____________

_________________

Applicant

FORM 3

(Regulation 5)

SAINT LUCIA

LICENCE

(Gaming Control Act: Section 21)

Licence No:

This is to certify that _________________________________ has been granted a

[Name of licensee]

________________________ licence.

[Name of licence]

This licence is valid until __________________________________________

[Insert date of expiry]

This licence granted is subject to the following restrictions/conditions (if for gaming operator licence include as a condition the premises in which gaming is to take place)—

1. _________________________________________________________

2. _________________________________________________________

3. _________________________________________________________

Dated this _______________________ day of _____________________

_____________________

Cabinet Secretary

NOT TRANSFERABLE

FORM 4A
(Regulation 6(1))
APPLICATION FOR AMENDMENT OF LICENCE
(Gaming Control Act: Section 23)
Licence No:
Type of Licence:
Name of Licensee:
Address:
1.	I ___________________________ hereby request an amendment to Licence No. __________________ for the following reasons:
	______________________________________________________
	______________________________________________________
	______________________________________________________
2.	Proposed amendment:
	______________________________________________________
	______________________________________________________
	______________________________________________________
	______________________________________________________
Dated this _________________. day of _____________
____________________
Licensee

FORM 4B

(Regulation 6(2))

AMENDMENT OF LICENCE

(Gaming Control Act: Section 23)

Licence No:

Type of Licence:

This is to certify that Licence No. __________________________________ held by _________________________ is amended as follows:

[Name of licensee]

__________________________________________________________

Dated this ________ day of _________________

___________________

Cabinet Secretary

FORM 5
(Regulation 7)
NOTICE OF INTENTION TO REVOKE
(Gaming Control Act: Section 23)
Licence No.:
Name of Licensee:
Address:
1.	Cabinet hereby notifies the above mentioned holder of a ____________________
	[Name of licence]
	licence that it intends to revoke the holder's licence under section 23 of the Gaming Control Act for the following reasons—
○	Cabinet is satisfied that the licence was obtained as a result of misleading false or fraudulent representation or in consequence of any incorrect information whether wilfully or not.
○	The licensee has breached any of the restrictions or conditions imposed under the licence.
○	Cabinet deems it expedient in the public interest.
2.	The licensee may no later than the _________________________________
	[specify date]
	show cause as to why the licence should not be revoked.
3.	If within the time specified above the licensee fails to comply with paragraph 2, his or her licence shall be revoked.
Dated this _______ day of _____________
________________
Cabinet Secretary

FORM 6
(Regulation 8)
NOTICE OF REVOCATION
(Gaming Control Act: Section 23)
Licensee No:
Name of Licensee:
Address:
Cabinet hereby notifies the above mentioned holder of _________________________
[type of licence]
licence that its licence has been revoked by Cabinet as at [enter date] under section 23 of the Gaming Control Act for the following reasons—
4.	Cabinet is satisfied that the licence was obtained as a result of misleading false or fraudulent representations or in consequence of any incorrect information, whether wilfully or not.
5.	The licensee has breached a restriction or condition imposed under the licensee.
6.	Cabinet deems it expedient in the public interest.
The decision of Cabinet is final.
Dated this ______ day of ______________
_______________
Cabinet Secretary

FORM 7
(Regulation 9(1))
APPLICATION FOR APPROVAL
(Gaming Control Act: Section 29)
FOR POSITION AS .............................................
WITH (gaming operator) .......................................
ON THE PREMISES KNOWN AS ...........................
1.	Full name (print surname in capital letters).
2.	Former names (if different from names given in paragraph 1 above).
3.	Aliases (if none used, state NONE).
4.	Full address at present time.
	P.O. Box
	Telephone (....................) Home (...........) Work (....................)
5.	List addresses in full for previous 10 years where different from address given in paragraph 4, stating dates.
6.	Date and place of birth (attach a copy of birth certificate).
7.	Nationality (if naturalised state the number, date and place of issue of the relevant certificate).
8.	Marital Status (if married, give the FULL NAME of spouse including WIFE'S MAIDEN NAME, and the DATE and PLACE of MARRIAGE).
9.	Dependents.
10.	Passport particulars (state number, date and place of issue).
11.	Are you or your spouse a director of any companies or a member of any partnership? (State YES or NO) .................. If YES, list the companies, firms or partnerships concerned, giving the name and address of each, and the type of business in which engaged.
12.	Give full details of your employment over the past 10 years, including the names and addresses of all employers, the related dates and positions held.
13.	List the games that you can deal proficiently.
14.	In relation to the gaming operator stated in this application, are you acting wholly or partly as a nominee or an agent for, or trustee of, another person, persons or organisation?
	(state YES or NO) .................. If YES, give the full details of such person, persons or organisations and the precise nature of your relationship or arrangements between you.
15.	To what extent have you a financial interest in the gaming operator stated in this application? (if none, state NONE. Otherwise give full details of interest).
16.	Have you ever been convicted of an offence (to include convictions in all countries, and to include all convictions relating to traffic offences? (state YES or NO) ……... If YES, give full details of the offence, the penalty, the Court at which you were convicted, and the date.
17.	(a)	Have you ever received a pardon of any type for any criminal offence in this country or in any other country? (state YES or NO) .................................
	(b)	Have you ever used, distributed or possessed any narcotic or hallucinogenic drug, barbiturate, amphetamine, or any other illegal substance? (state YES or NO) ..........................
	If yes, state whether you used, possessed or distributed the substance, the name of each substance involved and the dates of each such possession, use or distribution ...............
	............................................................................................................
	............................................................................................................
	............................................................................................................
	............................................................................................................
18.	Have you ever appeared in a court in any capacity whatsoever? (state YES or NO) .........
	If YES give details ....................................................................................
19.	Do you have any legal proceedings pending? (state YES or NO) ............ if yes, give full details.
20.	Has your spouse ever been convicted of an offence (minor traffic violations may be excluded? (state YES or NO) ......... If YES, give full details of the offence, the penalty, the court at which convicted, and the date.
21.	Have you or your spouse ever been declared bankrupt, or been the subject of a bankruptcy petition or ever received a judgement against you in a civil court? (state YES or NO) ................ If YES, give details.
22.	Give the names and addresses of all banks at which you have, or have had, an account of any type during the past 10 years (the Board of the Gaming Authority reserves the right to seek references and other information from bank managers).
23.	List all of the schools which you have attended after elementary level, stating dates.
24.	Give the membership details of clubs or organisations of which you are, or have been a member during the past 10 years (state the name of the club or organisation, address, type, dates of membership and any office held).
25.	Attach references from 3 persons who are well known to you, but to whom you are not related. (The referees should be responsible persons, preferably members of a recognized professional body and they should state the length of time for which they have been known to you).
26.	Attach 2 copies of a recent black and white photograph, passport size. Each copy must be signed and dated by a responsible person who can confirm your identity and certify the likeness of the photographs.
27.	Attach a full set of fingerprints taken at a police station or by a reputable agency, and certified accordingly (fingerprints from both hands are required).
	I certify that to the best of my knowledge and belief, the information given in this application is correct. I understand that the discovery of any statement which is false in a material particular may render me liable to prosecution.
	*I further understand that on arrival in Saint Lucia to take up employment of which this application is the subject, I shall be required to furnish to the Board of the Gaming Authority, a statement made before a notary public attesting to the accuracy of the information given in this application.
DATE .........................................			SIGNED ...........................................
*This paragraph applies only to overseas applicants.

FORM 7A
(Regulation 9(1))
AUTHORISATION FOR INFORMATION
(Gaming Control Act: Section 29)
Name _______________________
Address _____________________
1.	I have made application to the Board of the Gaming Authority for a certificate of approval and I hereby give my authorisation to any and all persons or organisations, to include Police or banks, for the release or any information regarding me, whether oral or written record or otherwise, to the Board Inspector on request.
2.	In connection with my application, I will not hold any person or organisation responsible in any way for the information which they furnish relative to me, whether such information is oral or written. Further, I will not hold any person or organisation liable for any publicity which may arise out of my application to the Board of the Gaming Authority.
3.	Date ..............................
Signed ..............................................
Witness .............................................
Address of witness ...............................

FORM 8
(Regulation 9(2))
SAINT LUCIA

CERTIFICATE OF APPROVAL
(Gaming Control Act: Section 29)
1.	Under Section 29 of the Gaming Control Act, this is to certify that [____________
	_________________________]
	Name of person
	has been approved by the Board of the Gaming Authority to perform the function of ..........................................................................................................
	on the licensed premises known as ................................................................
2.	Certificate of Approval No:
3.	Date of Certificate issued:
4.	Certificate valid until:
5.	Fee of EC$	Received.
..............................................
Chairperson
Board of Gaming Authority
NOT TRANSFERABLE