Data
Application form
Report and statistical data order form
Use this form if you want to order a:
•
Gaming Machine Report; or
OFFICE USE ONLY
•
Liquor Licence Premises List/Trading Hours Report
1. The NSW Office of Liquor, Gaming & Racing provides
By (circle): mail | OTC | fax | email
information and statistical data about the NSW liquor and
gaming industries.
Date received
2. There are a number of reports that OLGR can provide and you
Amount paid $
should complete the relevant parts B-C for the information
you need, and part D for payment.
Finalised by
3. Part B should be completed if you are purchasing a Gaming
Machine Report.
Date finalised
4. Part C should be completed if you are purchasing a Liquor
Licence Premises List or trading hours information.
5. You must clearly state the month or quarter and the year of the report(s) you require.
6. Please note that the standard request turnaround is 10 working days. Some requests may take longer.
7. Telephone orders cannot be accepted and we cannot invoice.
8. All amounts are GST inclusive.
9. For more information go to www.olgr.nsw.gov.au.
10. If you need help in completing this form email xxxx@xxxx.xxx.xxx.xx.
11. Lodge this application form with payment by one of the fol owing methods:
Post
Fax
Deliver to
Email
Office of Liquor,
Office of Liquor,
Office of Liquor,
xxxx@xxxx.xxx.xxx.xx
Gaming & Racing
Gaming & Racing
Gaming & Racing
GPO Box 7060
(02) 9842 8175
Level 6, 323 Castlereagh St
Sydney NSW 2001
Haymarket NSW 2000
PART A
APPLICANT DETAILS
Name
Premises/organisation
Address
Town/City
State
Postcode
Phone no. (daytime)
Email address
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Application form
PART B
GAMING MACHINE REPORTS
Types of Gaming Machine Report requested (please tick the appropriate report(s)) and the dates required (eg. Quarter ending June 2012)
1. Gaming Machine Quarterly Report by LGA – $150
This report includes gaming machine turnover, gaming machine net profit, gaming machine tax, number of authorised gaming machines and
number of premises by Local Government Area.
Club
Hotel
Quarter ending
2. Gaming Machine Annual Report by LGA – $300
This report includes gaming machine turnover, gaming machine net profit, gaming machine tax, number of authorised gaming machines
and number of premises by Local Government Area.
Club (year end is August)
Hotel
(year end is June) Year ending
3. State Rankings by Gaming Machine Profit, Quarterly Report – $150
This report includes the premises number, name, suburb, postcode, LGA and state profit ranking for hotels and premises number, name,
suburb, postcode, gaming machine numbers, current quarter state profit ranking and five previous years rankings for the same corresponding
quarter for clubs.
Club
Hotel
Quarter ending
4. State Rankings by Profit per Gaming Machine, Quarterly Report – $150
This report includes the premises number, name, suburb, postcode, LGA and state profit per gaming machine ranking for hotels and premises
number, name, suburb, postcode, gaming machine numbers, current quarter state profit per gaming machine ranking and five previous years
rankings for the same corresponding quarter for clubs.
Club
Hotel
Quarter ending
5. Gaming Machine Statistics Report – $150
This document contains three reports. The reports include:
a) Profit Range – number of venues, gaming machine turnover, gaming machine profit, gaming machine tax and number of authorised
gaming machines in each profit range.
b) Machine Range– number of venues, gaming machine turnover, gaming machine profit, gaming machine tax, number of authorised gaming
machines, average turnover per premises, average profit per premises, average tax per premises, average turnover per gaming machine,
average profit per gaming machine and average tax per gaming machine in each gaming machine range.
c) Profit Order – number of gaming machines, gaming machine tax, gaming machine profit and gaming machine turnover in ranges of 25.
Club
Hotel
Quarter ending
AMOUNT PAYABLE $
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PART C
LIQUOR LICENCE PREMISES LIST / TRADING HOURS
6. Liquor licence premises list
This list provides details of all liquor licences in NSW including the licence number, name, premises address, LGA, phone, fax, grant date,
status, licensee and postal address. Please indicate the number of reports you would like to buy. (Please note reports are run on the first
business day of each month).
$520 for 12 reports over a 12 month period
$50 per report
AMOUNT PAYABLE $
7. Number of Gaming Machines per Venue
The report will provide the number of gaming machines per venue in addition to the information contained in the Liquor licence premises
list above.
$100 per report
AMOUNT PAYABLE $
8. Trading hours list
This list provides details about licences in a specified LGA that have extended trading hours, trade after midnight or may trade for 24 hours.
It includes an LGA summary, licensee listing, trading hours, and 24 hour trading – clubs. Please indicate the number of reports you would like
to buy.
LGA required
$50 per report per LGA
AMOUNT PAYABLE $
PART D
PAYMENT
Pay the applicable fee† by :
Cheque (payable to ‘Office of Liquor, Gaming & Racing’)
Cash
Money order
Credit card†
Cheque drawer’s name
MasterCard† VISA†
Card no
Expiry date
CVV*
*These are the last 3 digits printed on the signature panel on the back of your credit card
Cardholder’s name
Cardholder’s signature
Payment amount † $
† Under NSW Government policy, a surcharge of 0.4% is added to the payment amount if paid by credit card.
Please visit www.olgr.nsw.gov.au/surcharge.asp for more information.
CONDITIONS OF USE OF INFORMATION
The use of the information is subject to the following:
• The information is subject to Crown copyright
• The information is only to be used by employees of the company, organisation, and/or person(s) purchasing the information
• The information is not to be published in any form
• The information is not to be sold or provided to any other organisation or person(s).
Any perceived discrepancies with the information provided must be reported within 7 days of receipt of the data.
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