Fillable Printable Sample Template for Raffle Ticket

Sample Template for Raffle Ticket

Off Premises Merchandise Raffle

N.J.A.C. 13:47-8.7

This illustration is provided for your convenience. While the form of the ticket may vary, the information

listed above must be contained on your printed ticket. If you require assistance with your ticket, please

contact the office of Legalized Games of Chance Control Commission at (973) 273-8000. This sample

ticket must be attached to the Application for Municipal Raffle License and submitted to the municipality.

Name

Address

City State ZIP code

Telephone Number

Ticket #

Name of Organization

List of Prizes Retail Values

Location of Drawing

Date of Drawing Time of Drawing

Purpose to which entire proceeds will be devoted

“No substitution of the offered prize may be made

and no cash will be given in lieu of the prize.”

Price of Ticket Ticket #

Stub Ticket

NJ LGCCC Identification# Municipal RL #

NJ LGCCC Identification # Municipal RL #

Sample Ticket

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