Pari-Mutuel Wagering and Cardroom Permit Forms

Permit Application,

effective:  2012-09-12

DBPR PMW-3010
Personal History Record,

effective:  2012-09-12

DBPR PMW-3030
Permit Transfer Application from one Existing Permitholder to Another Existing Permitholder,

effective:  2012-09-12

DBPR PMW-3040

 

Permitholder Application for Annual License and Operating Dates,

effective:  2016-12-13

DBPR PMW-3060
Permitholder Calendar,

effective: 2016-12-13

(Excel File)

DBPR PMW-3080
Surety Bond For Florida Pari-Mutuel Wagering,

effective 2016-12-13

DBPR PMW-3105
Permitholder Application for Annual License to Operate a Cardroom,

effective:  2014-07-21

DBPR PMW-3160
Officers and Directors,

effective:  2016-12-13

DBPR PMW-3190
Request for Release of Information and Authorization to Release Information,

effective:  2012-09-12

DBPR PMW-3195
List of Cardroom Business Occupational Licensees Providing Products and Services to a Cardroom,

effective:  2014-07-21

DBPR PMW-3220

Pari-Mutuel Wagering and Cardroom Licensing Forms

Animal Owner’s Temporary License Application,

effective:  2020-09-01

DBPR PMW-3110
Individual Occupational License Application,

effective:  2020-09-01

DBPR PMW-3120
Business Occupational License Application,

effective:  2020-09-01

DBPR PMW-3130
Disclosure for Individuals Related to a Business,

effective 2020-09-01

DBPR PMW-3140
Request for Waiver,

effective:  2020-09-01

DBPR PMW-3180
Request for Release of Information and Authorization to Release Information,

effective:  2012-09-12

DBPR PMW-3195
License Upgrade Application,

effective:  2011-09-11

DBPR PMW-3450
General Explanatory Description DBPR 0060
Request for Address or Name Change DBPR 0080
Duplicate License Request DBPR 0090

Pari-Mutuel Wagering Operations Forms

Veterinary Report of Medication,

effective:  2007-03-04

DBPR PMW-3050
Request for Stay,

effective:  2007-03-04

DBPR PMW-3090
Request for Appeal of Stewards’/Judges’ Ruling,

effective:  2007-03-04

DBPR PMW-3100
Veterinarian Report of Race-Day Salix Administration (SAMPLE) DBPR PMW-3280
Notification to Stewards/Judges of Split Sample Request,

effective:  2007-03-04

Approved Split Sample Laboratories, 2019-04-23

DBPR PMW-3290

 

Bleeder’s Certificate,

effective:  2007-03-04

DBPR PMW-3300
Request to Discontinue Salix,

effective:  2007-03-04

DBPR PMW-3310
Salix Certification Waiver,

effective:  2007-03-04

DBPR PMW-3330
Kennel Personnel Roster,

effective:  2007-03-04

DBPR PMW-3360

Pari-Mutuel Wagering and Cardroom Auditing Forms

Report of Escheated Outs,

effective:  2007-03-04

DBPR PMW-3510
Notification of Pari-Mutuel Operations DBPR PMW-3520
Statement of Proceeds for Charity Day Performances,

effective:  2007-03-04

DBPR PMW-3540
Charity Day Proceeds and Distribution,

effective:  2007-03-04

DBPR PMW-3550
Monthly Remittance Report On-Track,

effective:  2007-03-04

(Excel File)

DBPR PMW-3560
Monthly Remittance Report Intertrack,

effective:  2007-03-04 

(Excel File)

DBPR PMW-3570
Report of System Event or Malfunction,

effective:  2012-09-12

DBPR PMW-3580
Notification of Interstate Broadcasting DBPR PMW-3590
Notification of Intertrack Wagering,

effective:  2007-03-04

DBPR PMW-3600
Daily Tracking of Cardroom Jackpot,

effective:  2014-07-21

(Excel file)

DBPR PMW-3605
Totalisator System Checklist,

effective:  2012-09-12

DBPR PMW-3610
Retired Jai Alai Players’ Fund Distribution,

effective:  2007-03-04

DBPR PMW-3620
Tickets Purchased and Cashed by the Totalisator Company,

effective:  2007-03-04

DBPR PMW-3630
Cardroom Monthly Remittance Report (Excel file) DBPR PMW-3640

 

Slot Machine Gaming Forms

Disclosure for Individuals Related to a Business,

effective 2020-09-01

DBPR PMW-3140
Officers and Directors,

effective:  2016-12-13

DBPR PMW-3190
Permitholder Application for Annual Slot Machine License,

effective:  2017 May

DBPR PMW-3400
Permitholder Renewal Application for Annual Slot Machine License,

effective:  2013-09-26

DBPR PMW-3405
Slot Machine Employee Occupational License Application,

effective:  2020-09-01

DBPR PMW-3410
Slot Machine Business Entity Occupational License Application,

effective:  2020-09-01

DBPR PMW-3420
Slot Machine Storage and Maintenance Facility Supplemental Application DBPR PMW-3421
Slot Machine Certified Educational Facility License Application,

effective:  2013-09-26

DBPR PMW-3422
License Upgrade Application,

effective:  2020-09-01

DBPR PMW-3450
Surety Bond for Florida Slot Machine Licensee,

effective:  2020-09-01

DBPR PMW-3470
Slot Machine Activity,

effective:  2013-09-26  

(Excel file)

DBPR PMW-3480
Slot Operations Monthly Remittance Report,

effective:  2013-09-26

(Excel file)

DBPR PMW-3660
Slot Operations Cumulative Monthly Remittance Report,

effective:  2013-09-26

(Excel file)

DBPR PMW-3670
Slot Jackpot Prize/Cash Option Report,

effective:  2010-06-21

DBPR PMW-3680
Slot Machine and Component Application for Shipment,

effective:  2010-06-21

DBPR PMW-3900
Slot Machine and Component Application Shipment Record,

effective:  2010-06-21

DBPR PMW-3910
General Explanatory Description DBPR 0060

 

General Forms

Request for Address or Name Change DBPR 0080
Duplicate License Request DBPR 0090

Need Help?

Louis Trombetta, Director

Division of Pari-Mutuel Wagering
2601 Blair Stone Road
Tallahassee, FL 32399-1035

Telephone: 850.487.1395
Facsimile: 850.488.0550

All requests for publications, documents, forms, applications for licenses, permits and other similar information can be obtained by contacting the Customer Contact Center.