Minimum Bet Complaint Form

Personal Details

Title

First Name

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Surname

*

Address

*

Email

*

Telephone

*

Betting Account Details

Name of Approved Wagering Service Provider (WSP)

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If 'Other' please disclose the name of the operator

Betting Account ID

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Nature of Complaint

What is the nature of your complaint

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If 'Other' please provide details

Please provide details of the contact made with the WSP and the outcome of your inquiry, including any reasons given

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Attach any evidence of the above

Bet Details (complete if your complaint relates to a refusal to accept a fixed odds bet)

Date of Race (DD/MM/YYYY)

Venue (Racecourse)

Race Number

Details of bet: (include horse, stake and price)

How was the bet placed or attempted to be placed?

Was the bet a bet back (only applies to bets transacted between wagering operators)?

Time the bet was attempted to be placed with the wagering operator (HH:MM:SS AM/PM)

Time the bet was rejected by the wagering operator (HH:MM:SS AM/PM)

Attachments and other information

Please list any other documents that may assist in our investigation and attach copies of these documents to this form. This should include any written communication to/from the licensed wagering operator.

Is there any other information that may assist in our investigation? If yes, please provide details

Please specify and attach a copy of one form of photo identification to this form (Passport or Drivers Licence)

*

Additional Documentation

Declaration, Acknowledgements and Agreements

Full Name

*

Date (DD/MM/YYYY)

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Place (city or town)

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Section 1: I make the following acknowledgements to support my minimum bet limit complaint against an Approved WSP:

I am domiciled in Australia

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The bet was not a Betting Transaction on a betting exchange

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I had provided the WSP with sufficient funds to pay for the Relevant Fixed Odds Bet

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The bet was placed after 9am (Victorian time) on the day of the Victorian Thoroughbred Race, or after 2pm (Victorian time) for a night race meeting

*

The bet did not form part of a multi-bet

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The bet was not a retail betting transaction placed in a Retail Outlet

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The WSP has not already accepted a Relevant Fixed Odds Bet or a number of Relevant Fixed Odds Bets of the same bet type up to the relevant limit in clause 12.1.1 on that horse from me

*

There was not multiple identical Relevant Fixed Odds Bets from related/connected parties

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The bet was not generated via robotic or other systematic processes

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The Relevant Fixed Odds Bet was not placed from a proxy server

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The Relevant Fixed Odds Bet was not a promotional bet, including a bonus bet or free bet (whether in part or in whole), where I did not have to provide the full payment for the stake

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I am the beneficial owner of the bet and the cost of the bet has been borne by me

*

I have not engaged in any unauthorised scraping of the WSPs website

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I am not an employee/associate of an Approved WSP, or if I am I have not used any information that is not publicly available to inform my bet

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The Relevant Fixed Odds Bet is not contrary to the Rules of Racing and/or Laws

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The bet would not raise any serious integrity concerns for RVL

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Section 2: The WSP has not previously refused to accept a Relevant Fixed Odds Bet from me, establish an account, or place restrictions on me due to:

The fact that I have been warned off or disqualified under the Rules of Racing

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The fact that I have previously engaged in fraudulent activity

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The fact that I am on a relevant gambling self-exclusion register

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The fact that I have previously breached a material condition of my customer agreement with the WSP

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The fact that the WSP was unable to accept any bet (or the Relevant Fixed Odds Bet) from me by operation of any Laws, including but not limited to The Anti-Money Laundering and Counter-Terrorism Financing Act 2006 (Cth) or any responsible gambling legislation

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I acknowledge and agree that:

RVL may provide any relevant information provided by the Complainant to approved WSP’s
I have read the Minimum Bet Limit Policy FAQ’s
The RVL Minimum Bet Limit process will be strictly adhered to and any determination by RVL is binding and final

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Signature: (Please print your name)

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