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Proceeds of Crime (Money Laundering) and Terrorist Financing Regulations (SOR/2002-184)

Regulations are current to 2022-09-22 and last amended on 2022-06-29. Previous Versions

SCHEDULE 6(Section 71, subsection 131(3) and section 152)Report with Respect to Casino Disbursements

PART A

Information with Respect to Reporting Person or Entity and Place of Business Where Disbursement Is Made

  • 1* 
    Person’s or entity’s name
  • 2* 
    Identification number assigned to person or entity by Centre
  • 3* 
    Number that identifies place of business
  • 4* 
    Address of place of business
  • 5* 
    Contact person’s name
  • 6 
    Contact person’s e-mail address
  • 7* 
    Contact person’s telephone number

PART B

Information with Respect to Disbursement

  • 1* 
    Date of disbursement
  • 2* 
    Time of disbursement
  • 3* 
    Type and amount of disbursement
  • 4* 
    If disbursement is in funds, type and amount of each type of funds involved
  • 5* 
    If disbursement is not in funds, type of disbursement and its value
  • 6* 
    Method by which disbursement is made
  • 7* 
    Name of every person or entity involved in disbursement and their account number or policy number or, if no account number or policy number, identifying number
  • 8* 
    Type of transaction in which disbursement occurs
  • 9* 
    Purpose of disbursement

PART C

Account and Reference Number Information

  • 1* 
    Every account number and other equivalent reference number connected to transaction in which disbursement occurs
  • 2* 
    Type of account
  • 3* 
    Branch number, institution number and similar numbers connected to account or reference number
  • 4* 
    If account is casino account, address of casino where account is located
  • 5* 
    Name of each account holder
  • 6* 
    Type of fiat currency of account
  • 7 
    Date account opened

PART D

Information with Respect to Person Who Requests Disbursement

  • 1* 
    Person’s name
  • 2 
    Person’s alias
  • 3* 
    Person’s date of birth
  • 4* 
    Person’s address
  • 5 
    Person’s country of residence
  • 6 
    Person’s email address
  • 7 
    Person’s telephone number
  • 8* 
    Nature of person’s principal business or their occupation
  • 9 
    Identification number assigned to person by casino
  • 10* 
    Type of document or other information used to identify person, or to verify their identity, and number of document or number associated with information
  • 11* 
    Jurisdiction and country of issue of document or other information
  • 12 
    Name of person’s employer
  • 13 
    Type of device used by person who requests disbursement online
  • 14 
    Number that identifies device
  • 15 
    Internet Protocol address used by device
  • 16 
    Person’s user name
  • 17 
    Date and time of person’s online session in which disbursement is requested

PART E

Information with Respect to Entity That Requests Disbursement

  • 1* 
    Entity’s name
  • 2* 
    Entity’s address
  • 3 
    Entity’s telephone number
  • 4* 
    Nature of entity’s principal business
  • 5 
    Identification number assigned to entity by casino
  • 6* 
    Name of each person — up to three — who is authorized to bind entity or to act with respect to account
  • 7* 
    Type of document or other information used to identify entity, or to verify its identity, and number of document or number associated with information
  • 8* 
    Jurisdiction and country of issue of document or other information
  • 9 
    Type of device used by entity that makes request online
  • 10 
    Number that identifies device
  • 11 
    Internet Protocol address used by device
  • 12 
    Entity’s user name
  • 13 
    Date and time of entity’s online session in which disbursement is requested

PART F

Information with Respect to Person or Entity on Whose Behalf Disbursement Is Requested

  • 1* 
    Person’s or entity’s name
  • 2* 
    Person’s or entity’s address
  • 3 
    Person’s or entity’s email address
  • 4 
    Person’s or entity’s telephone number
  • 5* 
    Nature of person’s or entity’s principal business or their occupation
  • 6 
    Identification number assigned to person or entity by casino
  • 7 
    Type of document or other information used to identify person or entity, or to verify their identity, and number of document or number associated with information
  • 8 
    Jurisdiction and country of issue of document or other information
  • 9* 
    Relationship of person or entity to person or entity that requests disbursement
  • 10 
    In the case of a person,
    • (a) 
      their alias
    • (b) 
      their date of birth
    • (c) 
      their country of residence
    • (d) 
      their employer’s name
  • 11 
    In the case of an entity,
    • (a) 
      name of each person — up to three — who is authorized to bind entity or to act with respect to account
    • (b*) 
      its registration or incorporation number and jurisdiction and country of issue of that number

PART G

Information with Respect to Person or Entity That Receives Disbursement (if Different from Person or Entity in Part D, E or F)

  • 1* 
    Person’s or entity’s name
  • 2* 
    Person’s or entity’s address
  • 3 
    Person’s or entity’s email address
  • 4 
    Person’s or entity’s telephone number
  • 5 
    Nature of person’s or entity’s principal business or their occupation
  • 6 
    Identification number assigned to person or entity by casino
  • 7 
    Type of document or other information used to identify person or entity, or to verify their identity, and number of document or number associated with information
  • 8 
    Jurisdiction and country of issue of document or other information
  • 9* 
    Relationship of person or entity to person or entity that requests disbursement
  • 10 
    Relationship of person or entity to person or entity on whose behalf disbursement is requested
  • 11 
    User name of person or entity that receives payment online
  • 12 
    In the case of a person,
    • (a) 
      their alias
    • (b) 
      their date of birth
    • (c) 
      their country of residence
    • (d) 
      their employer’s name
  • 13 
    In the case of an entity,
    • (a) 
      name of each person — up to three — who is authorized to bind entity or to act with respect to account
    • (b) 
      its registration or incorporation number and jurisdiction and country of issue of that number
 
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