Application for Approval of a Linked Jackpot Arrangement

About this form

This form is to be used by a Gaming Machine Licensee applying for approval to operate a linked jackpot arrangement between gaming machines operated under an authorisation certificate held by the licensee. This application will not be considered unless it is made by a licensee and is complete with all supporting documentation provided.

Required supporting documentation:
A Sales Order or similar from an approved supplier. This document must be signed by an authorised person of the applicant and of the approved supplier.


Access Canberra

Phone: (02) 6207 0361

Payment options

Visa and MasterCard logos

Payments up to $10,000 can be made with either Visa or MasterCard.

Your personal information

Access Canberra uses this form to collect information which is necessary to allow the ACT Government to provide services to you. Personal Information may be used or disclosed in accordance with the Information Privacy Act 2014.

For details on the collection of personal information in this form please refer to the Access Canberra Information Collection Notice. If you have questions about how your information will be handled please see the Access Canberra Privacy Policy or contact us.