APPLICATION FOR LICENCE
- amusement machines
1 (2)
NB! One form per game location
Date
Applicant
Name of game organiser (e.g. company or individual person)
Corporate/Personal ID number
Delivery address for company (company or individual person)
Postcode
Telephone
Fax
E-mail
Fax
E-mail
City/Country
Name of contact person
Telephone
Game location
Name
Corporate/Personal ID number
Street address
Postcode
Telephone
Fax
Licence period (maximum 2 years)
From, date
To, date
Restaurant number
City/Country
For seasonal games, specify which games periods
Documents to attach to application
These documents only apply to physical persons
Bankruptcy-free certificate
Latest assessment decision
Excerpts from ban on trading activity register
Annual accounts/Profit and loss account
and balance sheet
Statutes or articles of association
These documents only apply to legal persons
Registration certificate
If the applicant is a physical person
I am not a legal guardian as per chap. 11 §7 of the Guardianship Code
Other information
DESCRIPTION OF GAME TO BE FILLED IN ON PAGE 2
Information on processing of personal data
Personal data submitted by the applicant in this application and later in the case as a result of the application may be processed automatically by Swedish Gambling Authority.
The aim of such processing is to administer matters relating to the licence, inspection and control in accordance with the Act on arrangements for certain gaming machines
(1982:636) and to carry out the necessary investigation. A registered party is entitled, on written application, to receive information from Swedish Gambling Authority
regarding what data relating to him/her is being processed. If the registered party discovers errors, he/she may request the data to be corrected. The information may be sent
to municipalities or be given out in accordance with the principle of free access to public records. The authority uses simplified notification.
Address: Swedish Gambling Authority, Box 199, SE-645 23 Strängnäs
Telephone: +46 (0)152-650 100, Fax: +46 (0)152-650 180, E-mail: [email protected]
IBAN: SE2512000000012810105081, Swift/BIC: DABASESX, Corp.ID number: 202100 - 3310
2 (2)
7\SHRIPDFKLQH
Number
Driving game
Dance machine
C omputer games
( computers programmed for games and connected in LAN enviroment or to the Internet)
Pinball
Motorcycle game
Simulator
Shooting game
Sports game
Video game
Other types of machines
Number
Other parties apart from the applicant who wish to recieve a copy of the license decision
Name
Delivery address
Box 199
Finningevägen 54 B
645 23 Strängnäs
Postcode
Telefon: 0152 - 650 100
Fax: 0152 - 650 180
Town/Country
[email protected]
www.lotteriinspektionen.se
Org. nr: 202100 - 3310
1 (1)
INFORMATION ON SIMPLIFIED NOTIFICATION for Swedish applicants only
When the Swedish Gambling Authority passes on your documents in this case, ‘simplified notification’ will be used. This
involves the following.
1.
The document sent to you will be sent by the Gambling Authority in an ordinary letter to the address the Gambling
Authority has been informed you can be reached at.
2.
At least one day later, the Gambling Authority will send you a card with a separate message stating that the document
in point 1 has been used. This is done to reduce the risk of error. You will thus receive two communications from
the Gambling Authority, normally at an interval of one day.
3.
You will normally be regarded as having received the document in point 1 once two weeks have passed since the
message as per point 2 has been sent. If the document you receive states that there is a deadline which starts to
run from the notification, this deadline applies once the two weeks have passed.
Remember that during the time your licence is valid, later documents resulting from your licence will be sent to you in a
simplified manner!
-
In order to be sure that no deadlines are missed, you must check your mail at least once every two weeks. If you
cannot do this (e.g. while you are away on holiday), you should inform the Gambling Authority of this in advance.
-
If you get a message in accordance with point 2, but do not receive the actual document in accordance with point
1, you should immediately report this to the Gambling Authority.
-
Always register a change of address with the Gambling Authority.
-
Always specify the case number when contacting the Gambling Authority.
-
Simplified notification may not always be used. Where relevant, notification will take place in another way,
which may mean, among other things, that you will need to send back your notification receipt to the Gambling
Authority.
Address: Swedish Gambling Authority, Box 199, SE-645 23 Strängnäs
Telephone: +46 (0)152-650 100, Fax: +46 (0)152-650 180, E-mail: [email protected]
IBAN: SE2512000000012810105081, Swift/BIC: DABASESX, Corp.ID number: 202100 - 3310