Gaming and wagering licence forms

Name of form When you should use this form
SafeNT criminal history check application Use this form to get a police criminal history check, which you will need to get many different types of licence.
Deed of release and indemnity DOCX (41.5 KB)
Deed of release and indemnity PDF (21.5 KB)
This form is part of the probity check process. It authorises police and licensing authorities to obtain information about you.
National police checking service informed consent form DOCX (59.4 KB)
National police checking service informed consent form PDF (90.4 KB)
This form is used in the process to renew a wide range of licences.
Gaming machine licences When you should use this form

Gaming machine venue licence application DOCX (139.7 KB)
Gaming machine venue licence application PDF (436.9 KB)

Use this form to apply for a gaming machine licence if you are any of the following:

  • the holder of a club, public hotel or tavern liquor licence referred to in Section 3 of the Gaming   Machine Act 1995
  • a transferee of an eligible liquor licence
  • an applicant for an eligible liquor licence.
Gaming machine application for licensee DOCX (77.2 KB)
Gaming machine application for licensee PDF (114.1 KB)

Use this form if you want to do any of the following:

  • change a gaming machine area
  • alter a gaming machine
  • install or cease linked jackpots
  • acquire or dispose of a gaming machine
  • temporarily disconnect a machine or machines.
Gaming machine increase application DOCX (177.8 KB)
Gaming machine increase application PDF (220.0 KB)

Use this form if you want to add more machines to your venue.

Gaming machine licence transfer application DOCX (76.1 KB)
Gaming machine licence transfer application PDF (256.6 KB)

Use this form to transfer a licence from one licensee to another.

Gaming machine substitution of premises application DOCX (66.9 KB)
Gaming machine substitution of premises application PDF (71.1 KB)

Use this form if you are shifting your business to a new place and want to move gaming machines to it.

Application for licence as a machine manager DOCX (51.8 KB)
Application for licence as a machine manager PDF (241.8 KB)
Use this form to apply for a licence as a gaming machine manager, and to renew a licence.
Notification of employment /cessation of a machine manager DOCX (63.7 KB)
Notification of employment /cessation of a machine manager PDF (71.0 KB)

Use this form to when your employ a licensed machine manager or one leaves your employment.

Apply for licence as a machine manager under Mutual Recognition DOCX (66.6 KB)
Apply for licence as a machine manager under Mutual Recognition PDF (172.2 KB)
Use this form if you already have a machine manager's licence elsewhere in Australia or in New Zealand and want to get one in the NT.
Application for licence as a machine repairer DOCX (62.3 KB)
Application for licence as a machine repairer PDF (234.7 KB)
Use this form if you want to become an approved repairer of gaming machines.
Application for licence as  a machine repairer under Mutual Recognition DOCX (68.0 KB)
Application for licence as a machine repairer under Mutual Recognition PDF (234.4 KB)

Use this form if you already have a machine repairer's licence elsewhere in Australia or in New Zealand and want to get one in the NT.

Gaming machine licence application for service contractor – body corporate DOCX (170.2 KB)
Gaming machine licence application for service contractor – body corporate PDF (562.8 KB)
Use this form if you are a body corporate that wants to become a service contractor.
Application for recognised manufacturers or suppliers of gambling equipment DOCX (53.9 KB)
Application for recognised manufacturers or suppliers of gambling equipment PDF (42.5 KB)
Use this form if you are a supplier of manufacturer of gambling equipment and want to be approved as a supplier in the NT.
Schedule of gaming machines DOCX (48.6 KB)
Schedule of gaming machines PDF (23.9 KB)
Use this form to provide information to the Director-General of Licensing about the gaming machines at your venue.
Gaming machine maintenance record DOCX (49.5 KB)
Gaming machine maintenance record PDF (32.5 KB)
Use this form to record details of maintenance carried out on gaming machines. It is to be kept at the venue.
Online gaming and wagering When you should use this form
Internet gaming key employee licence DOCX (59.3 KB)
Internet gaming key employee licence PDF (70.7 KB)
Use this form to apply for, or renew, a licence as a key employee for internet gaming.

Last updated: 04 February 2020

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