Forms

Forms

Pari-Mutuel Wagering and Cardroom Permit Forms

Permit Application, effective: 2012-09-12	FGCC PMW-3010
Personal History Record, effective: 2012-09-12	FGCC PMW-3030
Permit Transfer Application from one Existing Permitholder to Another Existing Permitholder, effective: 2012-09-12	FGCC PMW-3040
Permitholder Application for Annual License and Operating Dates, effective: 2016-12-13	FGCC PMW-3060
Permitholder Calendar (Excel file) effective: 2016-12-13	FGCC PMW-3080
Surety Bond For Florida Pari-Mutuel Wagering, effective 2016-12-13	FGCC PMW-3105
Permitholder Application for Annual License to Operate a Cardroom, effective: 2014-07-21	FGCC PMW-3160
Officers and Directors, effective: December 2025	FGCC PMW-3190
Request for Release of Information and Authorization to Release Information, effective: 2012-09-12	FGCC PMW-3195
List of Cardroom Business Occupational Licensees Providing Products and Services to a Cardroom, effective: 2014-07-21	FGCC PMW-3220

Pari-Mutuel Wagering and Cardroom Licensing Forms

Animal Owner’s Temporary License Application, effective: December 2025	FGCC PMW-3110
Individual Occupational License Application, effective: January 2026	FGCC PMW-3120
Business Occupational License Application, effective: January 2026	FGCC PMW-3130
Disclosure for Individuals Related to a Business, effective January 2026	FGCC PMW-3140
Request for Waiver, effective: January 2026	FGCC PMW-3180
Request for Release of Information and Authorization to Release Information, effective: 2012-09-12	FGCC PMW-3195
License Upgrade Application, effective: September 2020	FGCC PMW-3450
General Explanatory Description	FGCC 0060
Request for Address or Name Change	FGCC 0080
Duplicate License Request	FGCC 0090

Pari-Mutuel Wagering Operations Forms

Request for Stay, effective: 2007-03-04	FGCC PMW-3090
Request for Appeal of Stewards’/Judges’ Ruling, effective: 2007-03-04	FGCC PMW-3100
Notification to Stewards/Judges of Split Sample Request, effective: 2007-03-04 Approved Split Sample Laboratories, 2020-09-30	FGCC PMW-3290
Personnel Roster, effective: 2007-03-04	FGCC PMW-3360

Pari-Mutuel Wagering and Cardroom Auditing Forms

Report of Escheated Outs, effective: 2007-03-04	FGCC PMW-3510
Notification of Pari-Mutuel Operations	FGCC PMW-3520
Statement of Proceeds for Charity Day Performances, effective: 2007-03-04	FGCC PMW-3540
Charity Day Proceeds and Distribution, effective: 2007-03-04	FGCC PMW-3550
Monthly Remittance Report On-Track (Excel file) effective: 2007-03-04	FGCC PMW-3560
Monthly Remittance Report Intertrack (Excel file) effective: 2007-03-04	FGCC PMW-3570
Report of System Event or Malfunction, effective: 2012-09-12	FGCC PMW-3580
Notification of Interstate Broadcasting	FGCC PMW-3590
Notification of Intertrack Wagering, effective: 2007-03-04	FGCC PMW-3600
Daily Tracking of Cardroom Jackpot (Excel file) effective: 2014-07-21	FGCC PMW-3605
Totalisator System Checklist, effective: 2012-09-12	FGCC PMW-3610
Retired Jai Alai Players’ Fund Distribution, effective: 2007-03-04	FGCC PMW-3620
Tickets Purchased and Cashed by the Totalisator Company, effective: 2007-03-04	FGCC PMW-3630
Cardroom Monthly Remittance Report (Excel file)	FGCC PMW-3640
Uniform Reporting System Prescribed for Pari-Mutuel Permitholders (Excel file) effective: 2007-03-04	FGCC PMW-3690

Slot Machine Gaming Forms

Disclosure for Individuals Related to a Business, effective January 2026	FGCC PMW-3140
Officers and Directors, effective: December 2025	FGCC PMW-3190
Permitholder Application for Annual Slot Machine License, effective: 2017 May	FGCC PMW-3400
Permitholder Renewal Application for Annual Slot Machine License, effective: 2013-09-26	FGCC PMW-3405
Slot Machine Employee Occupational License Application, effective: January 2026	FGCC PMW-3410
Slot Machine Business Entity Occupational License Application, effective: January 2026	FGCC PMW-3420
Slot Machine Certified Educational Facility License Application, effective: 2013-09-26	FGCC PMW-3422
License Upgrade Application, effective: September 2020	FGCC PMW-3450
Surety Bond for Florida Slot Machine Licensee, effective: 2020-09-01	FGCC PMW-3470
Slot Machine Activity (Excel file) effective: 2013-09-26	FGCC PMW-3480
Slot Operations Monthly Remittance Report (PDF Spreadsheet file) effective: 2013-09-26	FGCC PMW-3660
Slot Operations Cumulative Monthly Remittance Report (PDF Spreadsheet file) effective: 2013-09-26	FGCC PMW-3670
Slot Jackpot Prize/Cash Option Report, effective: 2010-06-21	FGCC PMW-3680
Slot Machine and Component Application for Shipment, effective: 2010-06-21	FGCC PMW-3900
Slot Machine and Component Application Shipment Record, effective: 2010-06-21	FGCC PMW-3910
General Explanatory Description	FGCC 0060

General Forms

Request for Address or Name Change	FGCC 0080
Duplicate License Request	FGCC 0090