David J. Roberts, Director
Division of Pari-Mutuel Wagering
1940 North Monroe Street
Tallahassee, FL 32399
Phone: 850.487.1395
Fax: 850.488.0550
- Statistical Information
- Licensing
- Rulemaking
- Track / Fronton Information
- Association Links
- Greyhound Adoption
- Contact the Division
Division of Pari-mutuel Wagering
PARI-MUTUEL WAGERING AND CARDROOMS FORMS CENTER
| Pari-Mutuel Wagering and Cardroom Licensing | |
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All of our user forms have been rendered enterable PDF files. You may either print them and fill them out as in the past--or you may now fill them out directly on your computer. You may not submit them online, but you can fill them out and print the filled out form. NOTE: If you fill out a form using Adobe Acrobat Reader you will be able to save the blank form--but all of your data will be erased when you save it. One way around this is to save the blank form to your computer and fill it out using a different software program such as Foxit Reader (see link below). Please be aware that forms occasionally change and insure that you are using the latest version of our form. |
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| PERMIT FORMS | |
Permit Application |
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Personal History Record |
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Permit Transfer Application from one Existing Permitholder to Another Existing Permitholder |
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Permitholder Application for Annual License and Operating Dates |
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Permitholder Calendar |
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Surety Bond For Florida Pari-Mutuel Wagering |
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Permitholder Application for Annual License to Operate a Cardroom |
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Officers and Directors |
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Notice of Change of Cardroom Business Occupational Licensees Providing Products and Services to a Cardroom |
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| LICENSING FORMS | |
Animal Owner's Temporary License Application |
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Individual Occupational License Application |
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Individual Occupational License Renewal Application (May only be used by people with a valid license that expires on June 30, 2007.) |
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Business Occupational License Application |
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Business Occupational License Renewal Application (May only be used by people with a valid license that expires on June 30, 2007.) |
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License Upgrade Application |
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Request for Waiver |
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Officers and Directors |
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Request for Release of Information and Authorization to Release Information |
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General Explanatory Description |
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Request for Address or Name Change |
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Duplicate License Request |
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| OPERATIONS FORMS | |
Veterinary Report of Medication |
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Request for Stay |
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Request for Appeal of Stewards'/Judges' Ruling |
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Veterinarian Report of Race-Day Salix Administration (SAMPLE) |
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Notification to Stewards/Judges of Split Sample Request |
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Bleeder's Certificate |
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Request to Discontinue Salix |
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Salix Certification Waiver |
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| Notice of Violation and Hearing | DBPR PMW-3340 |
Kennel Personnel Roster |
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| AUDITING FORMS | |
| Report of Escheated Outs | DBPR PMW-3510 |
| Notification of Pari-Mutuel Operations | DBPR PMW-3520 |
| Statement of Proceeds for Charity Day Performances | |
| Charity Day Proceeds and Distribution | DBPR PMW-3550 |
| Report of System Event or Malfunction | DBPR PMW-3580 |
| Notification of Interstate Broadcasting | DBPR PMW-3590 |
| Notification of Intertrack Wagering | DBPR PMW-3600 |
| Daily Tracking of Cardroom Jackpot | DBPR PMW-3605 |
| Totalisator System Checklist | DBPR PMW-3610 |
| Retired Jai Alai Players' Fund Distribution | DBPR PMW-3620 |
| Tickets Purchased and Cashed by the Totalisator Company | DBPR PMW-3630 |
| COMPLAINT FORM | |
Uniform Complaint Form |
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| Problems with blank or corrupt files? | |
| Download Foxit Reader | |
callcenter@dbpr.state.fl.us |
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