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Kahnawake Gaming Commission

FORMS

Poker Rooms

The forms accessible from this page are required for applications and renewals of Poker Room Licences, Dealer Permits and Key Person Permits – and for other matters related to Poker Rooms that are licensed and regulated by the Commission.

*NOTE: All forms must be submitted in person at the Kahnawake Gaming Commission office. Our office hours are:  Monday to Friday 8:30 AM to 4:00 PM – CLOSED FOR LUNCH FROM 12:00 PM TO 1:00 PM

Download Poker Room Regulations

Download Criminal Record Information - Consent Form and Privacy Waiver

Download Full Disclosure Assurance

Download Applicable Fees

Download Schedule A - Approved Games

Download Schedule B - Repealed 25, Onerahtókha/April, 2012

Download Schedule C - Application for Poker Room Licence

Download Schedule D - Business Entity Information Form

Download Schedule E - Personal Information Form

Download Schedule F - Key Person Permit Application

Download Schedule G - Dealer Permit Application

Download Schedule H - Renewal Application

Download Schedule I - Written Request for Special Events Licence

Download Schedule J - Application to be Appointed an Approved Supplier - Repealed 26 Enníska/February, 2014

Download Schedule K - Comprehensive Self-Exclusion Request

Download Schedule K (French)- Comprehensive Self-Exclusion Request

Download Schedule L - Request to Revoke

Download Schedule L (French) - Request to Revoke

Download Schedule M - Request to Temporarily Close

Download Schedule N - Material Change Report

Download Schedule O - Request to be Declared Dormant

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P.O. Box 1799, Route 138,
Kahnawake Mohawk Territory,
Quebec, J0L 1B0, Canada

Fax:
+1 450 635 1139
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