Raffle License Application

Raffle licenses are regulated by the State of Illinois and are only issued to eligible not-for-profit organizations in accordance with 230 ILCS 15/0.01 et seq (State of Illinois Raffles Act) and Chapter 12 of the McHenry Municipal Code. This application MUST be accompanied by the not-for-profit’s Articles of Incorporation and/or Charter that reflects that the applicant organization has been incorporated for at least the last five (5) years prior to this application. This application and related materials must be received by the Office of the City Administrator NO LATER than fourteen (14) days prior to the start of raffle sales.

Organization Information

Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Address*field type single line
Street Number and Name, or PO Box Number
Input blocked. Maximum character limit of 4000 characters reached.
City, State, Zip*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Phone Number*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Emailfield type email
President of Organizationfield type single line
Input blocked. Maximum character limit of 4000 characters reached.

Applicant Information

Applicant Name*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Applicant Address*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Applicant Phone*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Applicant Email*field type email
Raffle Manager*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Raffle Manager Phone #field type single line
Input blocked. Maximum character limit of 4000 characters reached.

Raffle Information

Date(s)*field type single line
Dates of Raffle Ticket Sales (may not exceed 400 days)
Input blocked. Maximum character limit of 4000 characters reached.
Date of Winner Determination*field type single line
The date(s) of the drawing
Input blocked. Maximum character limit of 4000 characters reached.
Time of Winner Determination*field type single line
Input blocked. Maximum character limit of 4000 characters reached.
Location of Winner Determination*field type single line
Where will the drawing be held?
Input blocked. Maximum character limit of 4000 characters reached.
Item(s) to be raffled*field type single line
Item to be raffled, or 50/50 drawing, etc
Input blocked. Maximum character limit of 4000 characters reached.
Valuefield type single line
Cash/Retail/Aggregate Value of Raffle Prizes
Input blocked. Maximum character limit of 4000 characters reached.
Determinationfield type single line
Manner in which winner will be determined
Input blocked. Maximum character limit of 4000 characters reached.
Gross Anticipated Receiptsfield type single line
Input blocked. Maximum character limit of 4000 characters reached.
Certification
I do hereby certify that all statements made herein are true and correct to the best of my knowledge and further certify that the organization which I represent is qualified and eligible to obtain a raffle license in the City of McHenry according to the requirements as set forth in 230 ILCS 15/0.01 et se (State of Illinois Raffles Act) and the McHenry Municipal Code, Title 4 Chapter 11, and further certify that we will abide by all rules and regulations as set forth by the State of Illinois and the City of McHenry. Our Audit Information will be returned no later than ten (10) business days from the conclusion of the licensed raffle.
Acknowledgement*field type checkbox
AcknowledgementI understand that checking this box constitutes a legal signature and confirms that I have filled out this form to the best of my ability.
Signature*field type signature
Date*field type date