| CLASS OF CLAIM AND CATEGORY WITHIN CLASS |
Amount of revenue applied |
| CLASS A: Venue operators may claim up to 100 percent of revenue applied to a Class A purpose or activity. |
| Class A (a). |
Donations, gifts and sponsorship (including cash, goods and services) to another person resident in Victoria, not including to the club itself, for the purpose or activities set out below. |
| (i) |
any educational purpose; |
$0 |
| (ii) |
the provision of health services or care; |
$130 |
| (iii) |
services for the prevention and treatment of problem gambling and drug and alcohol addictions; |
$0 |
| (iv) |
housing assistance for disadvantaged persons; |
$0 |
| (v) |
the relief of poverty; |
$500 |
| (vi) |
the provision of services and assistance for the aged; |
$0 |
| (vii) |
the provision of services and assistance for young people; |
$25 |
| (viii) |
the protection and preservation of the environment; |
$0 |
| (ix) |
the provision of assistance to relieve distress caused by natural or other disasters; |
$0 |
| (x) |
the provision of advice, support and services to ex-service personnel, their carers and families; |
$0 |
| (xi) |
any other philanthropic or benevolent purpose; |
$0 |
| (xii) |
any sporting or recreational purpose, excluding any club that holds a venue operator’s licence. |
$5,075 |
| Class A (b). |
The cost of providing and maintaining sporting facilities for use by club members. |
$12,115 |
| Class A (c). |
The cost of any subsidy for the provision of goods and services but excluding alcohol. |
$2,637 |
| Class A (d). |
Voluntary services provided by members and/or staff of the club to another person in the community, in fulfilment of Class A(a)(i)-(xii) above. |
$0 |
| Class A (e). |
Advice, support and services provided by the RSL (Victorian Branch) to ex-service personnel, their carers and families. |
$0 |
| CLASS A – TOTAL |
$20,482 |
| CLASS B: Venue operators may claim an amount equal to the proportion of the club’s non-gaming revenue to its total revenue for Class B. |
|
Non-Gaming Revenue proportion % 0 |
| Class B (a). |
Capital expenditure. |
$0 |
| Class B (b). |
Financing Costs (including principal and interest). |
$0 |
| Class B (c). |
Retained earnings accumulated during the year. |
$0 |
| Class B (d). |
The provision of buildings, plant or equipment over $10,000 per item excluding gaming equipment or the gaming machine area of the venue. |
$0 |
| Class B (e). |
Operating costs. |
$276,208 |
| CLASS B – TOTAL |
$276,208 |
| CLASS C: Venue operators may claim up to 100 percent of revenue applied to a Class C purpose or activity. |
| Class C (a). |
The provision of responsible gambling measures and activities but excluding those required by law. |
$0 |
| Class C (b). |
Reimbursement of expenses reasonably incurred by volunteers. |
$0 |
| Class C (c). |
CBS preparation and auditing expenses to a maximum of $3,000. |
$453 |
| CLASS C – TOTAL |
$453 |
| CBS TOTAL (CLASS A + B + C) |
$297,143 |
| I, Joe Jakubowski, certify that:
|
| 1. |
The claims are consistent with the Ministerial Order made on 28 June 2012.
|
| 2. |
The following information is accurate for the financial year: |
| |
a) The percentage (if any) of the venue’s gaming revenue applied to community purposes or activities under Classes A, B and C.
b) The value of any non-financial contribution to community purposes (e.g. voluntary work) by, or on behalf of the venue operator, expressed as a percentage of the venue’s revenue.
c) Any amount payable by a gaming operator under a declaration made by the VGCCC under section 3.6.8(4A) of the Gambling Regulation Act 2003 (the Act), expressed as a percentage of the venue's gaming revenue. |
| |
The amount is |
| |
| less than |
|
| equal to |
|
| greater than |
X |
|
| |
8 1/3 per cent of the venue’s gaming revenue for that financial year, as the required by section 3.6.2 of the Act. |
| 3. |
The CBS in relation to POLISH COMMUNITY ASSOCIATION IN GEELONG INC, has been audited by the suitably qualified person of John Saija of Saija & Co Pty Ltd on 24/09/2013.
I confirm that an independent auditor’s statement dated 24/09/2013 has been received which states that, in the auditor’s opinion, this CBS presents fairly, in accordance with applicable Accounting Standards in Australia, and, is consistent with the auditor’s understanding of sections 3.6.9(2)(a) and (b) and section 3.6.9(3) of the Act, the POLISH COMMUNITY ASSOCIATION IN GEELONG INC,’s compliance with the Act for the financial year ended 30 June 2013.
|
| Declaration to be completed by the venue operator |
I, Joe Jakubowski, declare that:
|
|
| 1. |
The information contained in this CBS form is true and correct to the best of my knowledge. |
| 2. |
I have retained all relevant documentation used in the preparation and auditing of this CBS. |
| 3. |
I acknowledge that it is an offence to provide false or misleading information. |
I understand that by typing my name below, I am deemed to have signed this CBS form.
Joe Jakubowski, President |
|