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The following information is required by Schedule 11, Part 4, Paragraph 39(2) of the Gambling Act 2005.
This statement must be submitted during the period of three months beginning with the day on which the draw (or last draw) in the lottery took place.
It must be completed by two members of the Society appointed in writing for that purpose by the Society, or its governing body if applicable, and accompanied by a copy of that appointment.
All signatories must be over the age of 18 years.
As duly appointed members of the Society in compliance with the requirements of Schedule 11, Part 4, Paragraph 39(4), you hereby submit the following statutory return: