INSTRUCTIONS FOR FORM WV/RAF-1 
 (APPLICATION FOR CHARITABLE RAFFLE LICENSE) 
                                            
Charitable raffle licenses can be obtained by filing an application for a raffle 
license.  The application must provide the following information (WVC § 47-21-8):  
 
(Heading): The heading of the application  form must include the name and 
address of the organization that is applying for the license, the identification 
number and account number issued to the organization by letter from the State 
Tax Department, and the date that the letter was issued. 
 
IS THIS A RENEWAL APPLICATION?: If the application is for a new license, 
there is a mandatory 60-day filing period that must be observed before any raffle 
activities may be conducted. This period applies regardless of when the license 
is approved and issued. If the application is for a license renewal, the mandatory 
60-day filing period may be waived. However, licensees are urged to file their 
renewal applications prior to the expiration of their current license, to avoid 
interruption in their raffle activities.  
 
Phone Number: If the organization has a telephone number, it must be 
provided. If the organization has no telephone, then the address and telephone 
number of the person applying for the license must be provided. 
 
NAME AND ADDRESS OF STATE OR NATIONAL ORGANIZATION 
 
 If the applicant is a local branch or lodge of a state or national organization, it 
must provide the name and headquarters  address of the state or national 
organization with which it is affiliated.  
 
SECTION 1 - TAX-EXEMPT STATUS:  
 
 A copy of the organization’s IRS determination letter must accompany the 
application.  Exempt organizations that do not have an IRS determination letter 
must attach a letter explaining the nature of their exempt status.  
 For example: volunteer fire departments, rescue units, other similar volunteer 
community service organizations or associations, churches, or government 
subdivisions are eligible to apply for a charitable raffle license, even though they 
may not be required to have an I.R.S. exemption letter.  
 The West Virginia State Tax Department does not issue tax exemptions, but it 
recognizes exemptions issued by the Internal Revenue Service. You should 
consult the I.R.S. if you have questions  about the tax exempt status of your 
organization. 
 
SECTION 2 - TYPE OF LICENSE:  
 
                                           1

 Select the type of license that best suits your organization’s needs: 
  
ANNUAL LICENSE: An annual license entitles an organization to conduct 
unlimited raffles year-round.  
 
LIMITED LICENSE: A limited occasion license is issued for a specified period of 
time, and entitles the organization to conduct two raffles within a six-month 
period. If two or more organizations wish to conduct a joint raffle occasion, each 
participating organization must obtain a limited occasion license. An organization 
that does not hold an annual license may  obtain up to three limited occasion 
licenses per year. An organization that holds an annual license may obtain one 
limited occasion license per year. 
 
STATE FAIR LICENSE:         (Issued only to the West Virginia State Fair Board). 
 
EXEMPT CERTIFICATE:      An organization that is authorized to conduct raffles 
without a license under the provisions of WVC §47-21-3 may apply for an 
“Exempt Certificate” without charge.   See page 5 of the Handbook for further 
information regarding exempt raffles. The 60-day filing period does not apply to 
exempt raffles. 
 
AMOUNT ENCLOSED: Applications will not be processed unless the 
appropriate fee is paid. 
 
SECTION 3 – LOCATION OF RAFFLE  OCCASIONS 
 
       List the address or location of the  premises where raffle games will be 
held.  
       List the name of the owner of the premises. Indicate whether you own the 
premises, or are renting or leasing the premises. If you are renting or leasing the 
premises, copies of all rental or lease agreements must  be attached. Rental 
agreements that are not reflective of the fair market value may be disapproved by 
the Tax Commissioner. 
 
SECTION 4 – NAMES OF OFFICERS OF ORGANIZATION 
 
       List the names, home addresses and home telephone numbers of all of 
the officers, members of the board of directors, governors, or trustees of the 
organization. If necessary, attach a separate sheet. 
 
SECTION 5 – PERSONS IN CHARGE OF RAFFLE 
 
       List the names, titles, home addresses and home telephone numbers of 
three or more bona fide active members of the organization who will be 
responsible for the raffle operations. At least one of these persons must be 

                                   2

present at all times raffles are conducted. For a limited occasion license, only two 
names are required. 
 
SECTION 6 – NAME OF HIGHEST ELECTED OFFICER AND DESIGNEE 
 
 List the names, titles, home addresses and home telephone numbers of 
the highest elected officer of the licensee and his or her officially appointed 
designee. One of these persons must be present at all times raffles are 
conducted. 
 
SECTION 7 – MANDATORY INFORMATION 
 
 Indicate by circling the appropriate answer whether the organization has 
ever been denied a raffle license, or whether any previous license issued to the 
organization has been revoked or suspended. If the answer is “yes,” attach an 
explanation on a separate sheet. 
 Indicate whether any member of the  organization who will participate in 
any way in the conduct of raffles  has been convicted of a felony, or a 
misdemeanor for a gambling offense within the previous ten years. If the answer 
is “yes,” attach an explanation on a separate sheet.  
 
SECTION 8- NAME OF RAFFLE DISTRIBUTOR 
 
List the names, addresses and telephone numbers of the distributor from whom 
the licensee will purchase raffle boards and games. 
 
SECTION 9 – DISPOSITION OF PROCEEDS 
 
 Indicate the organization or organizations to which proceeds will be 
donated, using a separate sheet if necessary. 
 Indicate the intended charitable or public service purposes for which the 
raffle proceeds will be expended.  
 
SECTION 10 – PROOF OF EXISTENCE 
 
 In order to qualify for a raffle license, your organization must provide proof 
that it has been in existence in West Virginia for two years prior to the date of 
filing. Documentary proof may include a copy of your organization’s Certificate of 
Registration issued by  the Secretary of State,  and a copy of a business 
registration certificate issued by the State Tax Department. These documents are 
not required from organizations that are applying to renew their license, and have 
previously provided them. 
  
                                   3

SECTION 11 – CONCESSIONS 
 
 If a concession is to be operated by someone other than the licensee, a 
copy of any written agreement, or an explanation of any oral agreement, between 
the licensee and the concession operator must be attached to the application. 
  
SECTION 12 – AGREEMENT 
 
 By signing the application form, the authorized representative of the 
organization is affirming that the persons  in charge of the organization’s raffle 
operations and the officers of the applicant organization understand:   
(1) That it is a violation of the law to allow any unauthorized persons to conduct 
any part of the raffle games or concessions; 
(2) That the organization is required to file the reports and keep the records as 
provided by the law; and 
(3) That it is a crime to violate the provisions of the charitable raffle laws, and, in 
addition, that a violation may result in suspension or revocation of the 
organization’s license and denial of future licenses. 
 The signature on the application form by the authorized representative of 
the organization is that person’s certification that the information contained in the 
application is true to the best of his or her knowledge.  
 To avoid delays, make sure your application is complete, including your 
check for the appropriate fee, your IRS exemption letter (not required for 
renewals) and all other supporting documents, copies of all leases or rental 
agreements, and the signature of the person submitting the application. If the 
application form is not complete, your license will be denied. 
 The completed application form, along with a check for the applicable 
license fee, should be mailed to the Charitable Bingo/Raffle License Unit, P.O. 
Box 1143, Charleston, West Virginia 25324-1143. 
 
                         4