Application for Class 4 Gambling Venue/TAB Venue Consent Section A - Applicant Details Note: Consents are specific to the venue and cannot be held by an individual or group. The following applies to my application (please tick)* Application for a new venue consent to host gaming machines A venue with existing gaming machines applying to increase the number A venue which holds an existing class 4 consent applying to relocate Two or more clubs applying to merge Application for TAB Venue Consent Invalid Input Name of Applicant* Invalid Input Name of Contact Person* Invalid Input Name of Corporate Society/Club* Invalid Input Postal Address for Correspondence* Invalid Input Email:* Invalid Input Phone Number* Invalid Input Preferred method of contact Phone Email Post Invalid Input Next > Section B - Venue Details Are you operating a venue established prior to 17 October 2001 that has continuously held a licence since that date?* Yes No Invalid Input Note: Class 4 gaming machine venues established on or before 17 October 2001 may operate a maximum of 18 gaming machines. Venues require Council consent to increase the number of gaming machines that they operate. Class 4 gaming machine venues established after 17 October 2001 may operate a maximum of nine machines and require Council consent to operate any at all. Name of Venue* Invalid Input Street Address of Venue* Invalid Input Full Legal Description* Invalid Input Names of Owner and Management Staff Invalid Input Primary activity of venue (please select)* For private club activities For the sale of liquor for consumption on the premises For TAB venues as defined by section 5 of the Racing Industry Act 2020 Invalid Input Details of liquor licence applicable to the venue including restricted area Invalid Input Number of approved existing gaming machines and the number of new or additional gaming machines proposed Current 0123456789101112131415161718 Invalid Input Proposed 01234567891011121314151617 Invalid Input If applying to relocate or merge, name of venue and street address of where relocating/merging* Invalid Input Reason(s) for relocation/merge Invalid Input < PrevNext > Section C - Supporting Information Affected Party Consultation Form Please provide details of affected parties contacted prior to submitting this application. Ensure to attach a copy of their submission to your application Invalid Input Upload File* Add another file Invalid Input Declaration I declare that I hold the appropriate authority to submit this application and that the information supplied here is true and correct. I understand and agree that my contact details and all other information included with this application may be presented to the Hearings Commission in a public hearing and will be made accessible to the public. Name* Invalid Input Date* ... Invalid Input The name, email & phone number (and physical address if supplied) information requested as part of this application process is to ensure We link the application to the correct person That we have enough details to identify and contact the person if necessary to complete the application process. For more information on MPDC’s Privacy Policy please click here. Before clicking submit, check that you have everything you need by going through the Application Checklist. < PrevSubmit
