Fillable Printable Raffle Ticket Accountability Form - Michigan
Fillable Printable Raffle Ticket Accountability Form - Michigan
Raffle Ticket Accountability Form - Michigan
Charitable Gaming Division
101 E. Hillsdale, Box 30023
Lansing, Michigan 48909
(517) 335-5786
www.michigan.gov/cg
RAFFLE TICKET ACCOUNTABILITY
Complete this form for your records. Do not mail in.
COMPLETION: Required.
PENALTY: Failure to complete this form
may result in administrative action.
Authority: Act 382 of the Public Acts of 1972, as amended.
BSL-CG-1365(R8/10)
Organization Name Recordkeeper Organization ID Number License Number
Ticket Seller’s Name & Phone #
Tickets Issued For Sale Tickets or Stubs Returned
# of Tickets or
Stubs Not
Returned
Date # From # Through # of Tickets Date
# of Ticket
Stubs
Cash
Rec’d
# of Unsold
Tickets
Totals:
RAFFLE TICKET ACCOUNTABILITY INSTRUCTIONS
This form is designed to assist licensees in complying with the raffl e rules. If another ticket accounting method
is used by your organization (including the use of a computer program), it must contain, at a minimum, all the
information on the front of this form.
List each ticket seller’s name & phone #. For each seller, indicate:
The date the tickets were issued for sale.
The beginning and ending ticket numbers.
The number of tickets issued for sale.
The date tickets and/or ticket stubs were returned.
Amount of cash received.
The number of ticket stubs returned.
The number of unsold tickets returned.
Calculate and enter the number of tickets or stubs that the ticket seller has not returned.
If the same ticket seller is issued additional tickets to sell, another entry is made for that ticket seller.
