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

Regulations are current to 2019-11-19 and last amended on 2019-06-25. Previous Versions

SCHEDULE 8(Subsections 42(1), (3) and (4))Large Casino Disbursement Report

PART AInformation on Place of Business Where Disbursement Is Made

  • 1* 
    Identification number of place of business where disbursement is made (e.g., casino’s identification number, licence number or other identifying number), if applicable
  • 2* 
    Full name of reporting person or entity
  • 3* 
    Full address of place of business where disbursement is made
  • 4* 
    Name and telephone number of contact person

PART BInformation on Disbursement

  • 1* 
    Date of disbursement
  • 2 
    Time of disbursement
  • 3* 
    Purpose and details of disbursement
    • (a) 
      reason for disbursement (chip redemption, gaming voucher redemption, payout or other reason), amount received, currency of amount received
    • (b) 
      type of disbursement (cash, cheque, electronic funds transfer, deposit in account at financial institution or other form of disbursement), amount disbursed and currency of amount disbursed and, if applicable, name and account number of each person involved in the disbursement, other than a person referred to in item 2 of Part A or Part D or F, and branch or transit number of each of those accounts, and name and account number of each entity involved in the disbursement, other than an entity referred to in item 2 of Part A or Part E, and branch or transit number of each of those accounts
  • 4* 
    Method by which the disbursement is made (in person, by armoured car or by another method)

PART CCasino Account Information (if applicable)

  • 1* 
    Account number
  • 2* 
    Casino Identifier Number, if applicable
  • 3* 
    Type of account (credit, front money or other type of account)
  • 4* 
    Full name of each account holder
  • 5* 
    Type of currency of the account

PART DInformation on Person Requesting Disbursement

  • 1* 
    Person’s full name
  • 2 
    Client number provided by reporting person or entity, if applicable
  • 3* 
    Person’s full address
  • 4 
    Person’s personal telephone number
  • 5 
    Person’s country of residence
  • 6* 
    Type of document or other information used to identify person and number of document or number associated with information
  • 7* 
    Jurisdiction and country of issue of document or other information used to identify person
  • 8* 
    Person’s date of birth
  • 9 
    Person’s business telephone number
  • 10* 
    Person’s occupation

PART EInformation on Entity on Whose Behalf Disbursement Is Received (if applicable)

  • 1* 
    Entity’s full name
  • 2* 
    Entity’s incorporation number and jurisdiction of its incorporation, if applicable
  • 3* 
    Entity’s type of business
  • 4* 
    Entity’s full address
  • 5 
    Entity’s telephone number
  • 6 
    Full name of each person — up to three — who is authorized to bind the entity or act with respect to the account

PART FInformation on Person on Whose Behalf Disbursement Is Received (if applicable)

  • 1* 
    Person’s full name
  • 2* 
    Person’s full address
  • 3 
    Person’s personal telephone number
  • 4 
    Person’s business telephone number
  • 5 
    Type of document or other information used to identify person and number of document or number associated with information
  • 6 
    Jurisdiction and country of issue of document or other information used to identify person
  • 7 
    Person’s date of birth
  • 8 
    Person’s occupation
  • 9 
    Person’s country of residence
  • 10 
    Relationship of person requesting the disbursement to the person on whose behalf the disbursement is received
  • SOR/2008-21, s. 19
  • SOR/2009-265, ss. 6, 7
  • SOR/2016-153, ss. 97, 98
 
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