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This application must be completed and filed with the Office of the Village Manager not less than 30 days prior to the date set for the commencement of the distribution of the raffle chances. A $25 fee is required to hold a raffle. The applicant organization must be recognized as a non-profit entity. Completion of this application is pursuant to Chapter 14, Article 2 of Deerfield’s Municipal Code. Feel free to contact David Fitzgerald, Management Analyst, at 847-719-7400 with any questions.
Organization Name
Type of Organization
Address
City
State
Zip Code
Phone Number
Years in Village
Number of Members
President/Chairman
Date of Incorporation
Date of Incorporation
Place of Incorporation
Is your organization a bona fide nonprofit?
1. Yes
2. No
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Maximum Cost ($) per Chance
Retail Value ($) of Top Prize
Number of Raffles to be Conducted
Aggregate Retail Value ($) of All Prizes
The Raffle Manager must tender a Fidelity Bond to the Village in an amount equal to the aggregate value of the prizes to be awarded in the raffle. This requirement can be waived if the Raffle Manager submits a bond waiver in the form of proof that the organization’s membership or Board of Trustees have voted unanimously in favor of the waiver.
File Attachment Instructions
Please submit a fidelity bond and bond waiver.
Fidelity Bond
Bond Waiver
Bond Amount ($)
E-Signature, to agree to the following:
Type your signature to hereby certify that our organization is a bona fide non-profit (religious, charitable, labor, fraternal, educational, veterans’) organization which has been in existence for at least 5 years with a bona fide membership engaged in carrying out organizational objectives and we have received, understand and will adhere to applicable provisions of Chapter 14, Article 2 of the Deerfield Municipal Code.

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