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Forms

On this page are direct links to each of the applications and other forms that have been incorporated into the Commission’s regulations (California Code of Regulations, Title 4, Division 18, § 12002 et seq.), including not only Commission forms but also certain Bureau of Gambling Control (Bureau) forms.  The forms listed on this page are the official, most current revisions, as incorporated into the Commission’s regulations

• Responsible Gambling
  • Self-Restriction Form (CGCC-036, Rev. 04/08)
  • Self-Exclusion Form (CGCC-037, Rev. 04/08)

• General Forms
  • Notice of Address Change - (CGCC-032, New. 06/05)
  • Authorization to Release Information - (DGC-APP. 006, Rev. 03/08)

• Gambling Establishment Forms
• Owner Forms
  • Application for State Gambling License (CGCC-030, 05/08)
  • Request for Additional Authorized Permanent Tables (CGCC-027, 04/08)
  • Request for a Certificate to Operate Additional Tables on a Temporary Basis (CGCC-024, 04/08)
  • Gambling Establishment Annual Fee Calculation (CGCC-028, 08/07)
  • Request for Statewide Involuntary Exclusion of an Individual (CGCC-12362, New 10/08)
  • Notice to Applicants (BGC-APP-001,Rev. 11/07)
  • Declaration of Full Disclosure (BGC-APP-005, Rev. 11/07)
  • Authorization to Release Information (BGC-APP-006, Rev. 04/08)
  • Appointment of Designated Agent (BGC-APP-008, Rev. 11/07)
  • Cardroom Applicant's Spouse Supplemental Information for a State Gambling License (BGC-APP-009A, Rev. 04/08)
  • Instructions to Applicant’s Spouse (BGC-APP. 010, Rev. 05/08)
  • Applicant's Declaration, Acknowledgement and Agreement (Community Property Interest) (BGC-APP-011, Rev. 11/07)
  • Applicant's Declaration, Acknowledgement and Agreement (Sole and Separate Property) (BGC-APP-012, Rev. 11/07)
  • Spouse's Declaration, Acknowledgement and Agreement (Community Property Interest) (BGC-APP-013, Rev. 11/07)
  • Spouse's Declaration, Acknowledgement and Agreement (Sole and Separate Property) (BGC-APP-014, Rev. 11/07)
  • Gambling Establishment Owner Applicant – Individual Supplemental Background Investigation Information (BGC-APP-015A, Rev. 04/08)
  • Gambling Establishment Owner Entity Supplemental Information for State Gambling License (BGC-APP-015B, Rev. 04/08)
  • Gambling Establishment Supplemental Information for State Gambling License (BGC-APP-015C, Rev. 04/08)
  • Trust Supplemental Background Investigation Information (BGC-APP-143), New 05/08
  • Key Employee Report (BGC-LIC-101, New 04/08)
  • Request for Live Scan Service - Gambling Establishment Owner (BCII 8016, Rev. 03/07)
• Key Employee Forms
  • Application for Gambling Establishment Key Employee License (CGCC-031, 05/08)
  • Gambling Establishment Key Employee Supplemental Background Investigation Information (BGC-APP-016A, Rev. 04/08)
  • Request for Live Scan Service - Gambling Establishment Key Employee (BCII 8016, Rev. 03/07)
• Work Permit Forms
  • Application for Initial Regular and Work Permit/ Temporary Work Permit (CGCC-21, Rev. 04/08)
  • Application for Transfer of Work Permit (CGCC-22, Rev. 04/08)
  • Application for Work Permit Renewal /u>(CGCC-23, 04/08)
  • Application for Replacement Work Permit Badge(CGCC-26, Rev. 04/08)
  • Request for Live Scan Service - Gambling Establishment Work Permit(BCII 8016, Rev. 03/07)

• Gambling Equipment Manufacturer and Distributor Forms
  • Application for Registration of Manufacturers or Distributors of Gambling Equipment (CGCC-025, Rev. 04/08)
  • Antique Collector Exemption (CGCC-039, Rev. 04/08)
  • Quarterly Report (CGCC-040, Rev. 04/08)

• Third Party Proposition Player Services Provider Forms
  • Application for Third-Party Proposition Player Services License for Business Entities and Owners (CGCC-433, New 05/09)
  • Application for Third-Party Proposition Player Services License for Supervisors, Players, or Other Employees (CGCC-434, New 05/09)
  • Application for Third-Party Proposition Player Services Registration (CGCC-435, Rev. 09/04)
  • Third-Party Proposition Player Services Registration Supplemental Information (CGCC-436, Rev. 06/04)
  • Request for Replacement Third-Party Proposition Player Services Badge (CGCC-438, Rev. 09/04)
  • Request for an Additional/Transfer/Reinstatement Third Party Proposition Player Services Registration/License (CGCC-439, Rev. 09/04)
  • Third Party Proposition Player Services Employee Report (CGCC-440, Rev. 09/04)
  • Change in Status Form for a Third Party Proposition Player Services Registration (CGCC-441, Rev. 09/04)
  • Application for Contract Approval to Provide Proposition Player Services (BGC-APP-030, Rev. 05/09)
  • Appointment of Designated Agent for Owners and Proposition Players (BGC-APP-031, Rev. 11/07)
  • Level I Supplemental Information (BGC-APP-032, Rev. 11/07)
  • Level II Supplemental Information (BGC-APP-033, Rev. 11/07)
  • Level III Supplemental Information (BGC-APP-034A, Rev. 11/07)
  • Level III Supplemental Information - Business (BGC-APP-034B, Rev. 11/07)
  • Request for Approval of Playing Book Form (BGC-APP-036, New 05/09)
  • Request for Live Scan Service - Third Party (BCII 8016, Rev. 03/07)
  • Tax Forms

• Gambling Business Forms
  • Application for Gambling Business License for Business Entities and Owners (CGCC-533, New 05/09)
  • Application for Gambling Business License for Supervisors, Players, or Other Employees (CGCC-534, New 05/09)
  • Application for Gambling Business Registration (CGCC-535, Rev. 09/04)
  • Gambling Business Registration Supplemental Information (CGCC-536, Rev. 06/04)
  • Request for Conversion of a Gambling Business Registration to a License (CGCC-537, Rev. 04/08)
  • Request for Replacement Gambling Business Badge (CGCC-538, New 06/04)
  • Request for an Additional/Transfer/Reinstatement of Gambling Business Registration/License (CGCC-539, Rev. 09/04)
  • Gambling Business Employee and Independent Contractor Report (CGCC-540, Rev. 09/04)
  • Change in Status Form for a Gambling Business Registration (CGCC-541, Rev. 09/04)
  • Request for Live Scan Service- Third Party(BCII 8016, Rev. 03/07)
  • Tax Forms

• Bingo Forms
• Manufacturer and Distributor Forms
  • Application for Interim Approval of Bingo Card-Minding Device (CGCC-615, New 11/08)
  • Application Interim License for Bingo Equipment Manufacturers and Distributors (CGCC-610, New 03/09)
  • Request for Live Scan Service - Bingo Manufacturer and Distributor
• Nonprofit Organization Forms
  • Statement of Eligibility to Conduct Remote Caller Bingo(CGCC-618, New 03/09)
  • Application Interim License for Remote Caller Bingo(CGCC-620, New 03/09)
  • Request for Live Scan Service - Bingo Fiduciary
  • Request for Live Scan Service - Bingo Site Manager
  • Request for Live Scan Service - Bingo Caller
  • Application for Interim Work for Remote Caller Bingo(CGCC-622, New 03/09)
    • Request for Live Scan Service - Work Permit

Below are direct links to each of the applications, reports and other forms that are related to tribal gaming.  These forms are exempt from the rulemaking provisions of the Administrative Procedure Act (Gov. Code, Title 2, Div. 3, Pt. 1, Ch. 3.5, § 11340 et seq.) and, therefore, are not incorporated into the Commission’s regulations.  The forms listed below are the official, most current revision.

• Tribal Gaming Forms
  • Application for Initial and Renewal Finding of Suitability Tribal Key Employee (CGCC-TKE 01, Rev. 10/07)
  • Address and/or Authorized Agent Change Form (CGCC-500, 07/07)
  • Tribal-State Compact Gaming Device Certification Form (CGCC-C2009)
  • Request for Live Scan Service - Tribal Key Employee (BCII 8016, Rev. 03/07)

• Gaming Resources Supplier / Financial Source Provider Forms
  • Application for Finding of Suitablity (CGCC-100, Rev. 06/08)
  • Application for Registration as a Financial Source (CGCC-2, New 04/02)
  • Request for Live Scan Service - Gaming Resource Supplier(BCII 8016, Rev. 03/07)

There are additional Bureau Forms, not incorporated into the Commission’s regulations, which may also be needed for application, reporting or other purposes.