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Reporting casino disbursements to FINTRAC : FINTRAC’s compliance guidance

From: Financial Transactions and Reports Analysis Centre of Canada (FINTRAC)

This guidance explains the requirement to report casino disbursements to FINTRAC.

This guidance replaces the following guidance, which have been archived online:

Note:

In this guidance

Related links

1. Who must comply

All casinos must comply with the casino disbursement reporting requirements.

A casino is a government, organization, board or operator in Canada authorized to do business in Canada and that conducts and manages:

A registered charity authorized to carry on business in a casino for a period of 2 consecutive days or less, under the supervision of the casino, is not considered to be a casino.

In Canada, the provincial and territorial governments delegate the legal responsibility as to who can conduct and manage gaming activities (lottery scheme) at a casino. The reporting entity that is delegated this responsibility by the province or territory is then responsible for meeting the obligations of the Proceeds of Crime (Money Laundering) and Terrorist Financing Act (the Act) and Regulations for that casino.

A service provider can submit and correct a Casino Disbursement Report on your behalf. However, as the reporting entity, you are ultimately responsible for meeting the requirements under the Act and associated Regulations, even if a service provider is reporting on your behalf. This legal responsibility cannot be delegated.

For more information:

Legal references

2. What is a casino disbursement

A casino disbursement occurs when you make a single disbursement of an amount of $10,000 or more for any of the following:

This includes an amount paid out in cash, by cheque, by transfer or other methods to a casino client, or any other person or entity.

A disbursement does not include any amount that you pay out in casino chips, tokens or slot tickets, since these disbursements involve exchanging one form of casino product for another and the funds remain within the casino.

A reportable disbursement does not include the following:

Note: If you conduct a single disbursement in which you pay out an amount that covers both a reportable disbursement and a non-reportable disbursement, you must submit a Casino Disbursement Report for only the reportable disbursement.

Example

You:

  • redeem $18,000 in chips to a client by issuing a cheque for $10,000, and
  • deposit the remaining $8,000 to the client's front money account.

Your Casino Disbursement Report would include:

  • the total $18,000 of chips redemption (in the starting action), and
  • only the $10,000 disbursement for which you issued the cheque (reportable in the completing action).

The deposit of the remaining $8,000 to the client’s front money account is not included in the Casino Disbursement Report since it is not a reportable disbursement.

You are only required to report the total amount of chips paid out to the client for the types of reportable disbursements.

It is important to note that if the disbursement cheque issued had been less than $10,000 (below the reporting threshold amount), the disbursement would not have been reportable.

Legal references

3. When to submit a Casino Disbursement Report

You must submit a Casino Disbursement Report to FINTRAC when you make a disbursement of $10,000 or more in a single disbursement.

Note: You must submit a Casino Disbursement Report to FINTRAC within 15 calendar days after the day on which you make the disbursement.

Legal references

24-hour rule

You must also submit a Casino Disbursement Report to FINTRAC in accordance with the 24-hour rule. That is, you must submit a report when:

Note: You must wait until the end of your designated 24-hour period before reporting a disbursement of $10,000 or more to FINTRAC. This will ensure you have included in the Casino Disbursement Report all reportable disbursements based on your aggregation type.

For more information:

Legal references

Foreign currency

If a disbursement is in a foreign currency, you must convert the amount into Canadian dollars using the exchange rate published by the Bank of Canada in effect at the time of the disbursement to determine whether you have reached the reporting threshold amount of $10,000 CAD.

If an exchange rate is not published by the Bank of Canada, then you must use the rate you establish in the normal course of your business at the time of the disbursement.

Your process for establishing an exchange rate to determine if you have reached the reporting threshold amount should be outlined in your compliance policies and procedures.

Legal references

4. How to submit a casino disbursement report

You must submit a Casino Disbursement Report to FINTRAC electronically using the following options:

Note about paper form: If you do not have the technical capability to submit reports electronically to FINTRAC, you must submit reports in paper form.

Legal references

5. The form for reporting casino disbursements

In this section

Note:

Form structure

The form for reporting casino disbursements has 4 sections:

Structure of the Casino Disbursement Report form: Main sections and types of information for each section
Main sections of the form Type of information for each section

General information

  • Information about your business including contact details
  • 24-hour aggregation type and 24-hour period
  • Reporting entity report reference number

Disbursement information

  • Date and time of disbursement
  • Method of disbursement
  • Information about location where the disbursement was made
  • Whether the disbursement is below or above $10,000
  • Reporting entity transaction reference number

Starting action

  • Reason of disbursement
  • Amount and currency of starting action
  • Account information or other equivalent reference number involved in the starting action
  • Requester (person or entity who requested the disbursement and their associated information)
  • Third party requester (person or entity on whose behalf the disbursement was requested and their associated information)

Completing action

  • Type of disbursement
  • Amount and currency of disbursement
  • Account information or other equivalent reference number involved in the disbursement
  • Any other person or entity involved in the completing action and their associated information
  • Receiver, (person or entity who received the disbursement and their associated information)
  • Third party receiver (person or entity on whose behalf the disbursement was received and their associated information)

Note

Form highlights

The structure of the form allows you to include:

Note: Because you must provide a date and time for each disbursement, it is understood that all starting and completing actions within the disbursement also occur at this date and time. If it does not, you should add a new disbursement to the report.

Important information about the number of disbursements, starting actions and completing actions in a report

Example 1

Sam walks into ABC Casino and requests to withdraw $12,000 from his casino front money account. In exchange, Sam receives $12,000 in cash.

ABC Casino submits a Casino Disbursement Report indicating that Sam requested a disbursement with:

  • 1 starting action (the request to withdraw $12,000 from Sam’s casino front money account), and
  • 1 completing action (disbursement of $12,000 in cash to Sam)
Example 2

Alex is present at ABC Casino and requests to redeem casino chips for $22,000. Alex requests that $8,000 be paid out in cash, and to receive the remaining $14,000 in cheque.

ABC Casino submits a Casino Disbursement Report indicating that Alex requested a disbursement with:

  • 1 starting action (the request to redeem casino chips for $22,000), and
  • 2 completing actions
    • the disbursement of $8,000 in cash to Alex, and
    • the disbursement of $14,000 in cheque issued to Alex

6. Other requirements associated with casino disbursements

In this section

Compliance program

Your compliance program’s policies and procedures must outline your process and criteria on:

If you have an automated or triggering system in place to detect when a threshold amount is reached for reporting, a person should still assess the disbursement(s), as a best practice, to ensure the submission of a Casino Disbursement Report.

Your compliance program must also include training on suspected money laundering and terrorist financing activities in relation to your business.

For more information:

Suspicious transactions

In addition to reporting casino disbursements, you may also be required to submit a Suspicious Transaction Report to FINTRAC when you have reasonable grounds to suspect that a disbursement is related to the commission, or the attempted commission, of a money laundering or terrorist activity financing offence. Therefore, you may be required to submit a Casino Disbursement Report and a Suspicious Transaction Report for the same disbursement.

For more information:

Disbursements related to terrorist property

If a disbursement is related to property owned or controlled by or on behalf of a listed person or a terrorist group, you must not complete the disbursement.

You must submit a Terrorist Property Report to FINTRAC immediately once you are required to make a disclosure under the Criminal Code or the Regulations Implementing the United Nations Resolutions on the Suppression of Terrorism.

The property must be frozen under the Regulations Implementing the United Nations Resolutions on the Suppression of Terrorism, and the Criminal Code.

For more information:

Legal references

Electronic funds transfers

If a casino disbursement involves a reportable electronic funds transfer, then you must submit an Electronic Funds Transfer Report to FINTRAC in addition to a Casino Disbursement Report.

For more information:

Record keeping

When you submit a Casino Disbursement Report to FINTRAC, you must keep a copy of it for at least 5 years from the date the report was created.

For more information:

Legal references

Verifying the identity of persons

There are requirements on when and how to verify the identity of a person who receives a casino disbursement.

For more information:

Third party determination

There are requirements to determine whether a person or entity requesting a casino disbursement is acting on behalf of another person or entity.

For more information:

Voluntary self-declaration of non-compliance

If you discover instances of non-compliance related to your casino disbursement reporting requirements, FINTRAC strongly encourages you to report a voluntary self-declaration of non-compliance.

For more information:

Annex A: Field instructions to complete a casino disbursement report

This annex contains instructions on how to complete the fields in a Casino Disbursement Report.

In this annex

Note:

Standardized field instructions

This section contains instructions for:

In this section

Field categories

Fields are categorized as either:

Instructions for field categories
Field categories Instructions
Mandatory

These fields are indicated with an asterisk symbol (*) and must be completed.

Because a Casino Disbursement Report can include multiple disbursements made within 24 consecutive hours that total $10,000 or more, the information for some mandatory fields may not have been obtained at the time of the disbursement. In this case, the fields become "reasonable measures" fields, and the instructions for reasonable measures (below in this table) must be applied.

Note: If a Casino Disbursement Report contains multiple disbursements made within 24 consecutive hours and 1 of these disbursements is $10,000 CAD or more, then the mandatory fields will apply.

Legal references
  • Proceeds of Crime (Money Laundering) and Terrorist Financing Regulations, SOR/2002-184, subsection 152(2)
Mandatory for processing

These fields are indicated with a double dagger symbol (‡) and must be completed.  

Mandatory if applicable

These fields are indicated with a dagger symbol (†) and must be completed if they are applicable to you or the disbursement being reported.  

Reasonable measures

You must take reasonable measures to obtain the information for all non-mandatory fields in the report, if they are applicable.

Reasonable measures are the steps that you must take, as outlined in your policies and procedures, to obtain the information that can include asking the person or entity involved in the disbursement for the information.

If you obtain the information, you must report it. You must also provide the information if it is contained within your systems or records.

Legal references
  • Proceeds of Crime (Money Laundering) and Terrorist Financing Regulations, SOR/2002-184, section 152(1)

Name fields

Instructions for the name fields
Name fields Instructions
Surname Provide the last name of the person.
Given name

Provide the first name of the person.

Note: If a person has only a single name, enter "XXX" in the "Given name" field and the person's single name in the "Surname" field.

Other/Initial Provide the middle or other name(s) of the person, or their initial(s) if no other names apply.
Alias Provide the name a person uses, or by which they are known, other than the name provided under surname, given name, or other/initial.
Name of entity Provide the full name of the entity.

Address fields

Provide the address details in the structured or unstructured fields (as applicable) as explained below.

Structured address fields

Structured address fields include:

If you have the ability to separate the information

You must report it in the structured address fields.

For example, if a person lives at #10-123 Main Street, Richmond, British Columbia, Canada A1B 2C3, complete the address fields as follows:

Example illustrating how to provide information if you have the ability to separate address information
Structured address fields Information provided
Apartment/Room/Suite/Unit number 10
House/Building number 123
Street address Main Street
City Richmond
Country Canada
Postal code A1B 2C3
If you are unable to separate the address information into the structured address fields

If, for example, your system groups the Apartment/Room/Suite/Unit number with the House/Building number and Street address, then provide:

If there is no civic address

If a person or entity's address is in an area where there is no civic address, provide a description of the physical location.

For example, if a person lives in the third house to the right after the community center in Tinytown, Saskatchewan, Canada X1Y 2Z2, complete the address fields as follows:

Example illustrating how to provide information if there is no civic address
Structured address fields Information provided
Street address Third house to the right after the community center
City Tinytown
Province SK
Country Canada
Postal code X1Y 2Z2

Note: If you use the structured address fields, you cannot use the unstructured address fields to provide additional information.

Unstructured address field

You should only use the unstructured address field when it is not possible to separate the address information. This typically occurs when you are uploading a large volume of reports and the data originates from outside your organization. For example, when you are in final receipt of an electronic funds transfer and the foreign address of the person who requested the transfer information cannot be easily populated into the structured address fields.

If possible, enter information about the country in the Country field and provide the unstructured address information in the following format:

Invalid addresses

The following are not valid addresses, and should not be provided in either the structured or unstructured address fields:

A legal land description can be acceptable as long as the land description is specific enough to pinpoint the physical location of the client's address. If the legal land description refers to an area or a parcel of land on which multiple properties are located, the legal land description would not be sufficient.
Persons who are transient or have no fixed address

For persons who are transient (for example, travelling in a recreational vehicle or temporarily working in a camp) and have no fixed address, you are required to provide the following information:

Address information to provide for persons who are transient or have no fixed address
Type of person What to provide
Canadian residents Their permanent Canadian address, even if that is not where they are currently residing
Foreign clients travelling in Canada for a short period of time Their foreign residential address
Foreign clients living in Canada for a longer period of time (such as a student) The person's temporary Canadian address

Occupation/business fields

Instructions for the occupation/business fields
Occupational/business fields Instructions
Occupation

When entering occupation information, you should be as descriptive as possible. For example, if the person is:

  • a manager, provide the area of management, such as “hotel reservations manager” or “retail clothing store manager”
  • a consultant, provide the type of consulting, such as “IT consultant” or “forestry consultant”
  • a professional, provide the type of profession, such as “petroleum engineer” or “family physician”
  • a labourer, provide the type of labour performed, such as “road construction worker” or “landscape labourer”
  • not working, you should still be as descriptive as possible, and indicate “student,” “unemployed,” “retired,” etc.

You can enter a numeric classification code and the code title in this field (for example, NOC – National Occupational Classification). However, a numeric code on its own is not sufficient as you need a written description of the occupation as explained above.

Note: If your client indicates that they are the manager of Blue Moon Auto Parts Ltd., you would enter “manager of auto parts company” in the occupation field and “Blue Moon Auto Parts Ltd.” in the name of employer field as explained below.

Name of employer

Enter the name of the person’s employer.

Do not provide the name of a supervisor or manager.

This field is meant to capture the name of the business that employs the person.

If the person has multiple employers, you only need to provide one but it should be the person’s primary employer.

Providing the name of employer can augment the description of a person’s occupation. For example, “retail clothing store manager for ABC high-end clothing store” and “retail clothing store manager for XYZ discount clothing store” are more descriptive than “retail clothing store manager” on its own.

Nature of entity’s principal business

You should be as descriptive as possible when entering the entity’s principal business.

If the entity’s principal business is “sales,” provide the type of sales, such as “pharmaceutical sales” or “retail clothing sales.”

You can enter a numeric classification code and the code title in this field (for example, NAICS – North American Industry Classification System). However, a numeric code on its own is not sufficient, as you need a written description of the nature of the entity’s principal business as explained above.

Identification fields

Instructions for the identification fields
Identification fields Instructions
Identifier type

Select the identifier type for the person or entity as applicable.

If you use the dual process method to identify a person, you must provide details of both sources of information in the identifier type fields.

For more information on how to identify persons and entities, refer to:

If “Other,” please specify If the identifier type is not listed, select “Other” and provide details.
Number associated with identifier type

This is the number indicated on the identifier type that was used to verify the identity of the person or entity. For example, on a driver’s licence, the licence number is the identification number and on a Certificate of Incorporation, the incorporation number is the identification number.

Note: Don’t report a Social Insurance Number (SIN) to FINTRAC. In addition, you cannot use documentation for identification purposes where it is prohibited by provincial legislation.

Jurisdiction of issue (country, province or state)

Provide the country, province, or state that issued the documentation used to identify the person or entity.

How to provide the jurisdiction that issued the documentation used for identification
Type of jurisdiction What and how to provide
A country Enter that country as the jurisdiction of issue.
A province or state in Canada, the United States or Mexico Select the province or state code from the list of options.
A province or state outside Canada, the United States or Mexico

Provide:

  • that province or state name as the jurisdiction of issue, and
  • the corresponding country information

Telephone number fields

Instructions for the telephone number fields
Location of telephone number Instructions
Canada or the United States Enter the area code and local number (for example, 999-999-9999).
Outside Canada or the United States

Enter the:

  • country code
  • city code, and
  • local number using a dash (-) to separate each one

For example, “99-999-9999-9999” would indicate:

  • a 2-digit country code
  • a 3-digit city code, and
  • an 8-digit local number

Specific field instructions

This section contains instructions for the report fields and are laid out in the same order as they appear on the Casino Disbursement Report form.

Note: For some fields, where the instructions are not provided, refer to the Standardized field instructions section.

In this section

General information

Instructions for the fields under "General information"
Fields Instructions
* Reporting entity number

You must enroll in FINTRAC Web Reporting System (FWR) to submit reports electronically.

Provide the 7-digit identifier number assigned to you by FINTRAC at enrolment.

‡ Reporting entity report reference number

A number assigned to each report by:

  • you (the reporting entity), or
  • the individual or organization submitting the report on your behalf

This number must be unique to your business, meaning it can only be used once.

Whom can FINTRAC contact about this report?

Enter the contact information of the person you would like FINTRAC to liaise with in the event that a follow up is required.

You must ensure that all of your contacts’ information is up to date in FINTRAC Web Reporting System (FWR) prior to submitting your report(s).

Report information

Indicate whether the report is related to 1 or multiple disbursements that occurred within a consecutive 24-hour period.

When you provide a date and time, you must include the time zone. The fields below provide instructions for formatting.

Instructions for the fields under "Report information"
Fields Instructions
‡ 24-hour aggregation type

Indicate the type of aggregation used when multiple disbursements occur within a consecutive 24-hour period:

  • Receiver
  • On behalf of receiver
  • Requestor
  • On behalf of requestor, or
  • Not applicable

If the report is for 1 disbursement only, then aggregating disbursements does not apply and you should select "Not applicable".

Note: You must provide a start date/time and end date/time in the fields below, even if there is no aggregation and you select "not applicable" in the 24-hour aggregation type field.

‡ 24-hour period start date and time

Provide the start date and time of the 24-hour period.

You must include the time zone (that is, UTC offset) in the 24-hour period start time field.

You must enter the start time in the following format: HH:MM:SS±ZZ:ZZ.

For example, 1:25:06 pm in Ottawa, Ontario would be reported as 13:25:06-05:00.

‡ 24-hour period end date and time

Provide the end date and time of the 24-hour period.

If your 24-hour period starts at 8:00 am, it would end at 7:59 am the following day.

You must include the time zone (that is, UTC offset) in the 24-hour period end time field.

The field above provides instructions for formatting.

Note: The start date/time and end date/time that you provide will establish the 24-hour period in which you look for possible aggregate disbursements, and report all applicable disbursements within.

Because you must aggregate on each party separately (requested by, requested on behalf of, received by, or received on behalf of), it is possible to have multiple 24-hour periods (for example, a 24-hour period for requesters that is different than your 24-hour period for receivers).

Disbursement information

Information about the disbursement
Instructions for the fields under "Information about the disbursement"
Fields Instructions
* Date and time of disbursement

Enter the date and time of the disbursement.

It cannot be a future date.

A report can contain multiple disbursements that took place in different time zones, but these disbursements should all be within your 24-hour aggregation period that is indicated by the 24-hour period start date and time  and the 24-hour period end date and time  in the report. 

Examples

If your report indicates that the 24-hour period is from 12:00 am to 11:59 pm Eastern Standard Time (EST) and you have disbursements that occurred in both EST and Pacific Standard Time (PST) zones, you will need to do the following:

Instructions for disbursements that took place in different time zones
Time zone where disbursements have occurred Instructions
Eastern Standard Time (EST) zone

Include the disbursements in the report if they fall within your 24-hour period.

Pacific Standard Time (PST) zone

Convert the time of the disbursements to EST to determine if they fall within your 24-hour period.

If they fall within the 24-hour period after conversion, then include them in the report.

You can include these disbursements in PST or EST time as long as they are within your 24-hour period.

Your process to convert and report disbursements that occur in different time zones should be documented in your policies and procedures to ensure your reporting is consistent.

For more information:

* Method of disbursement

Select the method that describes how the disbursement was requested.

If the method is not listed, select "Other."

† If "Other," please specify If “Other” is selected, you must provide a brief description on how the disbursement was requested.
‡ Threshold indicator

Indicate whether the value of the disbursement made was above or below $10,000.

Select:

  • "above threshold" if the disbursement is equal to $10,000 or more
  • "below threshold" if it is under $10,000

Note: This is the total amount disbursed at the end of the 24-hour period.

‡ Reporting entity transaction reference number

This is a unique number assigned to each disbursement by:

  • you (the casino), or
  • the individual or organization submitting the report on your behalf 
Information about where the disbursement was made

Provide information about the physical location where the disbursement took place.

For example, if the disbursement was made at self-redemption kiosk, provide the reporting entity location number and address information for that kiosk.

If no physical location is applicable (for instance the disbursement was made online), provide the location number of your main location.

Instructions for the field under "Information about where the disbursement was made"
Field Instructions
* Reporting entity location number

This represents information about where the disbursement took place.

The location number is:

  • created and assigned to you by FINTRAC during the enrolment process to FINTRAC Web Reporting System (FWR), and
  • maintained by your FWR administrator

For more information about this, contact your FWR administrator.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (address fields)

† Street address

Same instructions (address fields)

† City

Same instructions (address fields)

District

Same instructions (address fields)

† Province or state (code)

Same instructions (address fields)

† Province or state (name)

Same instructions (address fields)

Sub-province and/or sub-locality

Same instructions (address fields)

† Country

Same instructions (address fields)

† Postal or zip code

Same instructions (address fields)

Starting action

Provide information about how the disbursement was started.

Instructions for the fields under "Starting action"
Fields Instructions

* Reason of disbursement

Select how the disbursement was initiated by the client.

It refers to what the client requested or presented to the casino to start the disbursement.

For example, a client requests a front cash withdrawal or requests a payment for the winnings of sports betting.

If the reason of disbursement is not in the list provided, you must select “Other” and provide the reason of disbursement.

† If "Other", please specify If “Other” is selected, you must provide a brief description of how the disbursement was initiated by the client.
† Amount

Enter the total amount of funds involved in the starting action.
If this amount was not in Canadian dollars, do not convert it to CAD, but provide the currency type in the next field.

† Currency

If the starting action was in funds, enter the currency code, including if it was in Canadian dollars.

If the currency type is not in the list provided, you must select “Other” and provide the full name of the currency.

† Value in Canadian dollars

Enter the value in Canadian dollars if the disbursement was not conducted using funds (for example, jewelry).

Account category

If the starting action involved an account or other equivalent reference number, you must provide the information detailed below.

Instructions for the fields under "Account category"
Fields Instructions

‡ Account category

Select the account type.

Note:

  • If it is a casino account, the “Casino account information” section for that starting action will be available for you to enter the account information.
  • If it is a financial institution account, the “Financial institution account information” section will be available for you to enter the financial institution account information.
  • If the disbursement involved a reference number, equivalent to an account number for non-account based organizations, the “Reference information” section will be available to you to enter the reference number.
  • If the disbursement did not involve a casino account, financial institution account or did not have a reference number associated with it, select “Not applicable”.
Casino account information
Instructions for the fields under "Casino account information"
Fields Instructions
† Casino account type

Select the type of casino account used in the disbursement:

† If "Other", please specify If “Other” is selected, you must provide the casino account type.
† Account number Provide the account number for the casino account.
† Account currency

Enter the currency code of the account, including if it was in Canadian dollars.

If the currency type is not in the list provided, you must select "Other" and provide the full name of the currency.

Date account opened

Enter the date the account was opened.

Address of casino where the account is held
Instructions for the fields under "Address of casino where the account is held"
Fields Instructions

† Casino identifier number where the account is held

Provide the unique number assigned by FINTRAC designated for the casino.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Casino account holder – person

Provide the information you have on 1 or multiple persons specified as account holders specific to the casino account.

Instructions for the fields under "Casino account holder – person"
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Casino account holder – entity

Provide the information you have on 1 or multiple entities specified as account holders specific to the casino account.

Instructions for the fields under "Casino account holder – entity"
Fields Instructions

† Name of entity

Refer to Name fields under "Standardized field instructions".

Financial institution account information
Instructions for the fields under "Financial institution account information"
Field Instructions

† Account type

Select the financial institution account type.

† If "Other", please specify

If “Other” is selected, you must provide the financial institution account type.

† Financial institution number

Provide the financial institution number.

† Branch number

Provide the branch number.

† Account number

Provide the account number for the financial institution account.

† Account currency code

Enter the currency code of the account, including if it was in Canadian dollars.

If the currency type is not in the list provided, you must select “Other” and provide the full name of the currency.

Date account opened

Provide the date the account was opened.

Financial institution account holder – person

Provide the information you have on 1 or multiple persons specified as account holders specific to the financial institution account.

Instructions for the fields under "Financial institution account holder – person"
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Financial institution account holder – entity

Provide the information you have on 1 or multiple entities specified as account holders specific to the financial institution account.

Instructions for the fields under "Financial institution account holder – entity"
Fields Instructions

† Name of entity

Refer to Name fields under "Standardized field instructions".

Reference number information
Instructions for the fields under “Reference number information”
Fields Instructions

† Reference number

If the starting action involved a reference number, provide it in this field.

Other number related to reference number

Provide any other number related to the reference number as applicable.

Information about the person requesting the disbursement
Instructions for the fields under "Information about the person requesting the disbursement"
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Alias

Same instructions (Name fields)

Client number

Provide the client number.

It is the unique identifying number assigned by the casino to the person requesting the disbursement.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Unstructured address details

Same instructions (Address fields)

Telephone number

Refer to Telephone number fields under “Standardized field instructions”.

Extension number

Same instructions (Telephone number fields)

Email address

Provide the email address of the person.

† Date of birth

Provide the date of birth of the person.

Country of residence

Enter the primary country of residence for the person.

It can be the same or different from the country entered in the address section.

† Occupation

Refer to Occupation/business fields under "Standardized field instructions".

Name of employer

Same instructions (Occupation/business fields)

Identification information of the person requesting the disbursement
Instructions for the fields under “Identification information of the person”
Fields Instructions

† Identifier type

Refer to Identification fields under "Standardized field instructions".

† If "Other," please specify

Same instructions (Identification fields)

† Number associated with identifier type

Same instructions (Identification fields)

† Jurisdiction of issue (country)

Same instructions (Identification fields)

† Jurisdiction of issue (province or state) (code)

Same instructions (Identification fields)

† Jurisdiction of issue (province or state) (name)

Same instructions (Identification fields)

Information about requesting the disbursement online – person
Instructions for the fields under "Information about requesting the disbursement online – person"
Fields Instructions

Person’s user name

Provide the user name of the person requesting the disbursement online.

Type of device used

Select which device was used to request the disbursement online.

† If "Other," please specify

If “Other” is selected, you must provide the type of device used.

Device identifier number

Provide the device identifier number.

It is a number assigned to the device, such as:

  • a Media Access Control (MAC) address, or
  • International Mobile Equipment Identity (IMEI) number

Internet protocol address

Provide the Internet Protocol (IP) address.

It is the unique identifying number assigned to every device connected to the internet.

Date and time of online session in which request was made

This is the date and time the requester accessed the online environment where the disbursement was requested.

Information about the entity requesting the disbursement
Instructions for the fields under "Information about the entity requesting the disbursement"
Fields Instructions

† Name of entity

Refer to Name fields under “Standardized field instructions”.

Client number

Provide the client number.

It is the unique identifying number assigned by the casino to the entity requesting the disbursement.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Unstructured address details

Refer to Unstructured address field under "Standardized field instructions".

Telephone number

Refer to Telephone number fields under "Standardized field instructions".

Extension number

Same instructions (Telephone number fields)

† Nature of the entity’s principal business

Refer to Occupation/business fields under "Standardized field instructions".

‡ Do you have incorporation or registration information?

This field is a “Yes/No” question.

Select “Yes” if you have the information.

Select ‘No’ if you do not have the information.

Is the entity incorporated or registered?

Select the incorporation or registration type.

Incorporation information of the entity requesting the disbursement
Instructions for the fields under "Incorporation information"
Fields Instructions

† Incorporation number

Provide the incorporation number of the entity requesting the disbursement for each jurisdiction where the entity is incorporated.

† Jurisdiction of issue (country) of incorporation

Provide the country that issued the documentation used to identify the entity for each jurisdiction where the entity is incorporated.

† Jurisdiction of issue (province or state) (code) of incorporation

Provide the jurisdiction of issue (province or state code) of incorporation for each jurisdiction where the entity is incorporated.

If the jurisdiction is a province or state in Canada, the United States or Mexico, select the code from the list of options.

† Jurisdiction of issue (province or state) (name) of incorporation

If the jurisdiction is outside Canada, the United States or Mexico, provide the name of the province or state.

Registration information of the entity requesting the disbursement
Instructions for the fields under "Registration information"
Fields Instructions

† Registration number

Provide the registration number of the entity requesting the disbursement for each jurisdiction where the entity is registered.

For Canadian entities, a registration number can include the 9-digit business number assigned to that entity by the Canada Revenue Agency (CRA).

† Jurisdiction of issue (country) of registration

Provide the country that issued the documentation used to identify the entity for each jurisdiction where the entity is registered.

† Jurisdiction of issue (province or state) (code) of registration

Provide the jurisdiction of issue (province or state) for each jurisdiction where the entity is registered.

If the jurisdiction is a province or state in Canada, the United States or Mexico, select the code from the list of options.

† Jurisdiction of issue (province or state) (name) of registration

If the jurisdiction is outside Canada, the United States or Mexico, provide the name of the province or state.

Identification information of the entity requesting the disbursement
Instructions for the fields under "Identification information of the entity"
Fields Instructions

† Identifier type

Refer to Identification fields under "Standardized field instructions".

† If "Other," please specify

Same instructions (Identification fields)

† Number associated with identifier type

Same instructions (Identification fields)

† Jurisdiction of issue (country)

Same instructions (Identification fields)

† Jurisdiction of issue (province or state) (code)

Same instructions (Identification fields)

† Jurisdiction of issue (province or state) (name)

Same instructions (Identification fields)

Person(s) authorized to bind the entity or act with respect to the account (up to 3)

If the requester is an entity, you must provide the information for up to 3 persons who are authorized to:

Instructions for the fields under "Person(s) authorized to bind the entity or act with respect to the account"
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Information about requesting the disbursement online – entity
Instructions for the fields under "Information about requesting the disbursement online – entity"
Fields Instructions

Entity’s user name

Provide the user name of the entity requesting the disbursement online.

Type of device used

Select which device was used to request the disbursement online.

† If "Other," please specify

If “Other” is selected, you must provide the type of device used.

Device identifier number

Provide the device identifier number.

It is a number assigned to the device, such as:

  • a Media Access Control (MAC) address, or
  • International Mobile Equipment Identity (IMEI) number

Internet protocol address

Provide the Internet Protocol (IP) address.

It is the unique identifying number assigned to every device connected to the internet.

Date and time of online session in which request was made

This is the date and time the requester accessed the online environment where the disbursement was requested.

On behalf of requester indicator
Instructions for the fields under "On behalf of requester indicator"
Fields Instructions

‡ Was this disbursement requested on behalf of another person or entity?

This field is a "Yes/No" question.

Select "Yes" if the disbursement was requested on behalf of another person or entity.

Information about the person on whose behalf the disbursement was requested

If the disbursement was requested on behalf of another person, you must include the relevant information.

Instructions for the fields under "Information about the person on whose behalf the disbursement was requested"
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Alias

Same instructions (Name fields)

Client number

Provide the client number.

It is the unique identifying number assigned by the casino to the the disbursement was requested was requested.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Unstructured address details

Refer to Unstructured address field under "Standardized field instructions".

Telephone number

Refer to Telephone number fields under "Standardized field instructions".

Extension number

Same instructions (Telephone number fields)

Email address

Provide the email address of the person.

Date of birth

Provide the date of birth of the person.

Country of residence

Enter the primary country of residence for the person.

It can be the same or different from the country entered in the address section.

† Occupation

Refer to Occupation/business fields under "Standardized field instructions".

Name of employer

Same instructions (Occupation/business fields)

Identification information of the person on whose behalf the disbursement was requested
Instructions for the fields under "Identification information of the person"
Fields Instructions

Identifier type

Refer to Identification fields under "Standardized field instructions".

† If "Other," please specify

Same instructions (Identification fields)

Number associated with identifier type

Same instructions (Identification fields)

Jurisdiction of issue (country)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (code)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (name)

Same instructions (Identification fields)

Relationship of the person on whose behalf the disbursement was requested to the person or entity requesting the disbursement
Instructions for the fields under “Relationship of the person named above to the person or entity requesting the disbursement”
Fields Instructions

† Relationship

Select the nature of the relationship of the person on whose behalf the disbursement was requested to the person or entity requesting the disbursement.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Information about the entity on whose behalf the disbursement was requested

If the disbursement was requested on behalf of another entity, you must include the relevant information.

Instructions for the fields under “Information about the entity on whose behalf the disbursement was requested”
Fields Instructions

† Name of entity

Refer to Name fields under "Standardized field instructions".

Client number

Provide the client number.

It is the unique identifying number assigned by the casino to the entity requesting the disbursement.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Unstructured address details

Refer to Unstructured address field under "Standardized field instructions".

Telephone number

Refer to Telephone number fields under "Standardized field instructions".

Extension number

Same instructions (Telephone number fields)

Email address

Provide the email address of the entity.

† Nature of the entity’s principal business

Refer to Occupation/business fields under "Standardized field instructions".

‡ Do you have incorporation or registration information?

This field is a “Yes/No” question.

Select “Yes” if you have the information.

Select ‘No’ if you do not have the information.

Is the entity incorporated or registered?

Select the incorporation or registration type.

Incorporation information of the entity on whose behalf the disbursement was requested
Instructions for the fields under “Incorporation information”
Fields Instructions

† Incorporation number

Provide the incorporation number of the entity for each jurisdiction where the entity is incorporated.

† Jurisdiction of issue (country) of incorporation

Provide the country that issued the documentation used to identify the entity for each jurisdiction where the entity is incorporated.

† Jurisdiction of issue (province or state) (code) of incorporation

Provide the jurisdiction of issue (province or state code) of incorporation for each jurisdiction where the entity is incorporated.

If the jurisdiction is a province or state in Canada, the United States or Mexico, select the code from the list of options.

† Jurisdiction of issue (province or state) (name) of incorporation

If the jurisdiction is outside Canada, the United States or Mexico, provide the name of the province or state.

Registration information of the entity on whose behalf the disbursement was requested
Instructions for the fields under “Registration information”
Fields Instructions

† Registration number

Provide the registration number of the entity for each jurisdiction where the entity is registered.

For Canadian entities, a registration number can include the 9-digit business number assigned to that entity by the Canada Revenue Agency (CRA).

† Jurisdiction of issue (country) of registration

Provide the country that issued the documentation used to identify the entity for each jurisdiction where the entity is registered.

† Jurisdiction of issue (province or state) (code) of registration

Provide the jurisdiction of issue (province or state code) of registration for each jurisdiction where entity is registered

If the jurisdiction is a province or state in Canada, the United States or Mexico, select the code from the list of options.

† Jurisdiction of issue (province or state) (name) of registration

If the jurisdiction is outside Canada, the United States or Mexico, provide the name of the province or state.

Identification of the entity on whose behalf the disbursement was requested
Instructions for the fields under “Identification information of the entity”
Fields Instructions

Identifier type

Refer to Identification fields under "Standardized field instructions".

† If "Other," please specify

Same instructions (Identification fields)

Number associated with identifier type

Same instructions (Identification fields)

Jurisdiction of issue (country)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (code)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (name)

Same instructions (Identification fields)

Person(s) authorized to bind the entity on whose behalf the disbursement was requested or act with respect to the account (up to 3)
Instructions for the fields under “Person(s) authorized to bind the entity or act with respect to the account”
Fields Instructions

Surname

Refer to Name fields under "Standardized field instructions".

Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Relationship of the entity on whose behalf the disbursement was requested to the person or entity requesting the disbursement
Instructions for the fields under “Relationship of the entity named above to the person or entity requesting the disbursement”
Fields Instructions

† Relationship

Select the nature of the relationship of the entity on whose behalf the disbursement was requested to the person or entity requesting the disbursement.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Completing action

Information about the disbursement

Provide information about how the disbursement was completed.

Instructions for the fields under "Information about the disbursement"
Fields Instructions

* Type of disbursement

Select how the disbursement was completed.

If the type of disbursement is not in the list provided, you must select “Other” and provide the type of disbursement

† If "Other," please specify

If “Other” is selected, you must provide a brief description of how the disbursement was completed.

† Amount

Enter the total amount of funds involved in the completing action.

If this amount was not in Canadian dollars, do not convert it to CAD, but provide the currency type in the next field.

† Currency

If the completing action was in funds, enter the currency code, including if it was in Canadian dollars.

If the currency type is not in the list provided, you must select “Other” and provide the full name of the currency.

† Value in Canadian dollars

Enter the value in Canadian dollars if the disbursement was not conducted using funds (for example, jewelry).

Account category

If the completing action involved an account or other equivalent reference number, you must provide the information detailed below.

Instructions for the fields under “Account category ”
Fields Instructions

‡ Account category

Select the account type.

Note:

  • If it is a casino account, the “Casino account information” section for that completing action will be available for you to enter the account information.
  • If it is a financial institution account, the “Financial institution account information” section will be available for you to enter the financial institution account information.
  • If the disbursement involved a reference number, equivalent to an account number for non-account based organizations, the “Reference information” section will be available to you to enter the reference number.
  • If the disbursement did not involve a casino account, financial institution account or did not have a reference number associated with it, select “Not applicable”.
Casino account information
Instructions for the fields under “Casino account information”
Fields Instructions

† Casino account type

Select the type of casino account used in the disbursement.

† If "Other," please specify

If “Other” is selected, you must provide the casino account type.

† Account number

Provide the account number for the casino account.

† Account currency

Enter the currency code of the account, including if it was in Canadian dollars.

If the currency type is not in the list provided, you must select “Other” and provide the full name of the currency.

Date account opened

Provide the date the account was opened.

Address of casino where account is held
Instructions for the fields under "Address of casino where account is held"
Fields Instructions

† Casino identifier number where the account is held

Provide the unique number assigned by FINTRAC designated for the casino.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Casino account holder – person

Provide the information you have on 1 or multiple persons specified as account holders specific to the casino account.

Instructions for the fields under "Casino account holder – person"
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Casino account holder – entity

Provide the information you have on 1 or multiple entities specified as account holders specific to the casino account.

Instructions for the fields under "Casino account holder – entity"
Fields Instructions

† Name of entity

Refer to Name fields under "Standardized field instructions".

Financial institution account information
Instructions for the fields under “Financial institution account information”
Field Instructions

† Account type

Select the financial institution account type.

† If "Other", please specify

If “Other” is selected, you must provide the financial institution account type.

† Financial institution number

Provide the financial institution number.

† Branch number

Provide the branch number.

† Account number

If the disbursement involves an account at a financial entity provide that account number.

† Account currency

Enter the currency code of the account, including if it was in Canadian dollars.

If the currency type is not in the list provided, you must select “Other” and provide the full name of the currency.

Date account opened

Provide the date the account was opened.

Financial institution account holder – person

Provide the information you have on 1 or multiple persons specified as account holders specific to the financial institution account.

Instructions for the fields under "Account holder – person"
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Financial institution account holder – entity

Provide the information you have on 1 or multiple entities specified as account holders specific to the financial institution account.

Instructions for the fields under "Financial institution account holder – entity
Fields Instructions

† Name of entity

Refer to Name fields under "Standardized field instructions".

Reference information
Instructions for the fields under "Reference information"
Fields Instructions

† Reference number

If the disbursement involved a reference number, provide it in this field.

Other number related to reference number

Provide any other number related to the reference number as applicable.

Involved in the completing action
Instructions for the fields under “Involved in the completing action”
Fields Instructions

‡ Was there any other person or entity involved in the completing action?

This field is a “Yes/No” question.

Select “Yes” if there was any other person or entity involved in the completing action.

Note: The other person or entity cannot be the same as the person or entity who requested the disbursement, on whose behalf the disbursement was requested, the person or entity receiving the disbursement, or on whose behalf the disbursement was received.

If you have information about other persons involved in the completing action, you must include it.

Information about the other person involved in the completing action
Instructions for the fields under "Information about the person involved in the completing action"
† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

† Account number

Provide the account number of the person involved in the completing action.

It is acceptable to include the financial institution number and branch number as part of an account number.

† Policy number

Provide the policy number.

† Identifying number

If there is no account or policy number, provide an identifying number if available.

Other entity involved in the completing action
Instructions for the fields under "Information about the entity involved in the completing action"
† Name of entity

Refer to Name fields under "Standardized field instructions".

† Account number

Provide the account number of the entity involved in the completing action.

It is acceptable to include the financial institution number and branch number as part of an account number.

† Policy number

Provide the policy number.

† Identifying number

If there is no account or policy number, provide an identifying number if available.

Information about the person receiving the disbursement
Instructions for the fields under “Information about the person receiving the disbursement”
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Alias

Same instructions (Name fields)

Client number

Provide the client number.

It is the unique identifying number assigned by the casino to the person receiving the disbursement.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Unstructured address details

Refer to Unstructured address field under "Standardized field instructions".

Telephone number

Refer to Telephone number fields under "Standardized field instructions".

Extension number

Same instructions (Telephone number fields)

Email address

Provide the email address of the person.

Online user name

Provide the online user name of the person.

Date of birth

Provide the date of birth of the person.

Country of residence

Enter the primary country of residence for the person.

It can be the same or different from the country entered in the address section.

Occupation

Refer to Occupation/business fields under "Standardized field instructions".

Name of employer

Same instructions (Occupation/business fields)

Identification information of the person receiving the disbursement
Instructions for the fields under "Identification information of the person"
Fields Instructions

Identifier type

Refer to Identification fields under "Standardized field instructions".

† If "Other," please specify

Same instructions (Identification fields)

Number associated with identifier type

Same instructions (Identification fields)

Jurisdiction of issue (country)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (code)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (name)

Same instructions (Identification fields)

Relationship of the person receiving the disbursement to the person or entity requesting the disbursement
Instructions for the fields under “Relationship of the person named above to the person or entity requesting the disbursement”
Fields Instructions

† Relationship

Select the nature of the relationship of the person receiving the disbursement to the person or entity requesting the disbursement.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Relationship of the person receiving the disbursement to the person or entity on whose behalf the disbursement was requested
Instructions for the fields under “Relationship of the person named above to the person or entity on whose behalf the disbursement was requested”
Fields Instructions

Relationship

Select the nature of the relationship of the person receiving the disbursement to the person or entity on whose behalf the disbursement was requested.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Information about the entity receiving the disbursement
Instructions for the fields under "Information about the entity receiving the disbursement"
Fields Instructions

† Name of entity

Refer to Name fields under "Standardized field instructions".

Client number

Provide the client number of the entity.

It is the unique identifying number assigned by the casino to the entity receiving the disbursement.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apartment/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Unstructured address details

Refer to Unstructured address field under "Standardized field instructions".

Telephone number

Refer to Telephone number fields under "Standardized field instructions".

Extension number

Same instructions (Telephone number fields)

Email address

Provide the email address of the entity.

Online user name

Provide the online user name of the entity.

Nature of entity’s principal business

Refer to Occupation/business fields under "Standardized field instructions".

‡ Do you have incorporation or registration information?

This field is a “Yes/No” question.

Select “Yes” if you have the information.

Select ‘No’ if you do not have the information.

Is the entity incorporated or registered?

Select the incorporation or registration type.

Incorporation information of the entity receiving the disbursement
Instructions for the fields under “Incorporation information”
Fields Instructions

Incorporation number

Provide the incorporation number of the entity receiving the disbursement for each jurisdiction where the entity is incorporated.

Jurisdiction of issue (country) of incorporation

Provide the country that issued the documentation used to identify the entity receiving the disbursement for each jurisdiction where the entity is incorporated.

Jurisdiction of issue (province or state) (code) of incorporation

Provide the jurisdiction of issue (province or state code) of incorporation for each jurisdiction where the entity is incorporated.

If the jurisdiction is a province or state in Canada, the United States or Mexico, select the code from the list of options.

Jurisdiction of issue (province or state) (name) of incorporation

If the jurisdiction is outside Canada, the United States or Mexico, provide the name of the province or state.

Registration information of the entity receiving the disbursement
Instructions for the fields under “Registration information”
Fields Instructions

Registration number

Provide the registration number of the entity receiving the disbursement for each jurisdiction where the entity is registered.

For Canadian entities, a registration number can include the 9-digit business number assigned to that entity by the Canada Revenue Agency (CRA).

Jurisdiction of issue (country) of registration

Provide the country that issued the documentation used to identify the entity receiving the disbursement for each jurisdiction where the entity is registered.

Jurisdiction of issue (province or state) (code) of registration

Provide the jurisdiction of issue (province or state) for each jurisdiction where the entity is registered.

If the jurisdiction is a province or state in Canada, the United States or Mexico, select the code from the list of options.

Jurisdiction of issue (province or state) (name) of registration

If the jurisdiction is outside Canada, the United States or Mexico, provide the name of the province or state.

Identification information of the entity receiving the disbursement
Instructions for the fields under “Identification information of the entity”
Fields Instructions

Identifier type

Refer to Identification fields under "Standardized field instructions".

† If "Other," please specify

Same instructions (Identification fields)

Number associated with identifier type

Same instructions (Identification fields)

Jurisdiction of issue (country)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (code)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (name)

Same instructions (Identification fields)

Person(s) authorized to bind the entity receiving the disbursement or act with respect to the account (up to 3)

You must provide the information for up to 3 persons who are authorized to:

Instructions for the fields under “Person(s) authorized to bind the entity or act with respect to the account”
Fields Instructions

Surname

Refer to Name fields under "Standardized field instructions".

Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Relationship of the entity receiving the disbursement to the person or entity requesting the disbursement
Instructions for the fields under “Relationship of the entity named above to the person or entity requesting the disbursement”
Fields Instructions

† Relationship

Select the nature of the relationship of the entity receiving the disbursement to the person or entity requesting the disbursement.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Relationship of the entity receiving the disbursement to the person or entity on whose behalf the disbursement was requested
Instructions for the fields under “Relationship of the entity named above to the person or entity on whose behalf the disbursement was requested”
Fields Instructions

Relationship

Select the nature of the relationship of the entity receiving the disbursement to the person or entity on whose behalf the disbursement was requested.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

On behalf of receiver indicator
Instructions for the fields under "On behalf of receiver indicator"
Fields Instructions

‡ Was this disbursement received on behalf of another person or entity?

This field is a "Yes/No" question.

Select "Yes" if the disbursement was received on behalf of another person or entity.

Information about the person on whose behalf the disbursement was received

If the disbursement was received on behalf of another person, you must include the relevant information.

Instructions for the fields under “Information about the person on whose behalf the disbursement was received”
Fields Instructions

† Surname

Refer to Name fields under "Standardized field instructions".

† Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Alias

Same instructions (Name fields)

Client number

Provide the client number.

It is the unique identifying number assigned by the casino to the person on whose behalf the disbursement was received.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apt/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Unstructured address details

Refer to Unstructured address field under "Standardized field instructions".

Telephone number

Refer to Telephone number fields under "Standardized field instructions".

Extension number

Same instructions (Telephone number fields)

Email address

Provide the email address of the person.

Online user name

Provide the online user name of the person.

Date of birth

Provide the date of birth of the person.

Country of residence

Enter the primary country of residence for the person.

It can be the same or different from the country entered in the address section.

Occupation

Refer to Occupation/business fields under "Standardized field instructions".

Name of employer

Same instructions (Occupation/business fields)

Identification information of the person on whose behalf the disbursement was received
Instructions for the fields under “Identification information of the person”
Fields Instructions

Identifier type

Refer to Identification fields under "Standardized field instructions".

† If "Other," please specify

Same instructions (Identification fields)

Number associated with identifier type

Same instructions (Identification fields)

Jurisdiction of issue (country)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (code)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (name)

Same instructions (Identification fields)

Relationship of the person on whose behalf the disbursement was received to the person or entity receiving the disbursement
Instructions for the fields under “Relationship of the person named above to the person or entity receiving the disbursement”
Fields Instructions

† Relationship

Select the nature of the relationship of the person on whose behalf the disbursement was received to the person or entity receiving the disbursement.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Relationship of the person on whose behalf the disbursement was received to the person or entity requesting the disbursement
Instructions for the fields under “Relationship of the person named above to the person or entity requesting the disbursement”
Fields Instructions

Relationship

Select the nature of the relationship of the person of the person on whose behalf the disbursement was received to the person or entity requesting the disbursement.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Information about the entity on whose behalf the disbursement was received
Instructions for the fields under “Information about the entity on whose behalf the disbursement was received ”
Fields Instructions

† Name of entity

Refer to Name fields under "Standardized field instructions".

Client number

Provide the client number of the entity.

House/Building number

Refer to Address fields under "Standardized field instructions".

Apartment/Room/Suite/Unit number

Same instructions (Address fields)

† Street address

Same instructions (Address fields)

† City

Same instructions (Address fields)

District

Same instructions (Address fields)

† Province or state (code)

Same instructions (Address fields)

† Province or state (name)

Same instructions (Address fields)

Sub-province and/or sub-locality

Same instructions (Address fields)

† Country

Same instructions (Address fields)

Postal or zip code

Same instructions (Address fields)

Unstructured address details

Refer to Unstructured address field under "Standardized field instructions".

Telephone number

Refer to Telephone number fields under "Standardized field instructions".

Extension number

Same instructions (Telephone number fields)

Email address

Provide the email address of the entity

Online user name

Provide the online user name of the entity

Nature of entity’s principal business

Refer to Occupation/business fields under "Standardized field instructions".

‡ Do you have incorporation or registration information?

This field is a “Yes/No” question.

Select “Yes” if you have the information.

Select ‘No’ if you do not have the information.

Is the entity incorporated or registered?

Select the incorporation or registration type.

Incorporation information of the entity on whose behalf the disbursement was received
Instructions for the fields under “Incorporation information”
Fields Instructions

Incorporation number

Provide the incorporation number of the entity on whose behalf the disbursement was received for each jurisdiction where the entity is incorporated.

Jurisdiction of issue (country) of incorporation

Provide the country that issued the documentation used to identify the entity on whose behalf the disbursement was received for each jurisdiction where the entity is incorporated.

Jurisdiction of issue (province or state) (code) of incorporation

Provide the jurisdiction of issue (province or state code) of incorporation for each jurisdiction where the entity is incorporated.

If the jurisdiction is a province or state in Canada, the United States or Mexico, select the code from the list of options.

Jurisdiction of issue (province or state) (name) of incorporation

If the jurisdiction is outside Canada, the United States or Mexico, provide the name of the province or state.

Registration information of the entity on whose behalf the disbursement was received
Instructions for the fields under “Registration information”
Fields Instructions

Registration number

Provide the registration number of the entity on whose behalf the disbursement was received for each jurisdiction where the entity is registered.

For Canadian entities, a registration number can include the 9-digit business number assigned to that entity by the Canada Revenue Agency (CRA).

Jurisdiction of issue (country) of registration

Provide the country that issued the documentation used to identify the entity on whose behalf the disbursement was received for each jurisdiction where the entity is registered.

Jurisdiction of issue (province or state) (code) of registration

Provide the jurisdiction of issue (province or state) for each jurisdiction where the entity is registered.

If the jurisdiction is a province or state in Canada, the United States or Mexico, select the code from the list of options.

Jurisdiction of issue (province or state) (name) of registration

If the jurisdiction is outside Canada, the United States or Mexico, provide the name of the province or state.

Identification information of the entity on whose behalf the disbursement was received
Instructions for the fields under “Identification information of the entity”
Fields Instructions

Identifier type

Refer to Identification fields under "Standardized field instructions".

† If "Other," please specify

Same instructions (Identification fields)

Number associated with identifier type

Same instructions (Identification fields)

Jurisdiction of issue (country)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (code)

Same instructions (Identification fields)

Jurisdiction of issue (province or state) (name)

Same instructions (Identification fields)

Person(s) authorized to bind the entity on whose behalf the disbursement was received or act with respect to the account
Instructions for the fields under “Person(s) authorized to bind the entity or act with respect to the account”
Fields Instructions

Surname

Refer to Name fields under "Standardized field instructions".

Given name

Same instructions (Name fields)

Other/Initial

Same instructions (Name fields)

Relationship of the entity on whose behalf the disbursement was received to the person or entity receiving the disbursement
Instructions for the fields under “Relationship of the entity named above to the person or entity receiving the disbursement”
Fields Instructions

† Relationship

Select the nature of the relationship of the entity on whose behalf the disbursement was received to the person or entity receiving the disbursement.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Relationship of the entity on whose behalf the disbursement was received to the person or entity requesting the disbursement
Instructions for the fields under “Relationship of the entity named above to the person or entity requesting the disbursement”
Fields Instructions

Relationship

Select the nature of the relationship of the entity on whose behalf the disbursement was received to the person or entity requesting the disbursement.

† If "Other," please specify

If “Other” is selected, you must specify the nature of the relationship.

Annex B: Scenarios

The examples and scenarios used in this guidance are intended to help explain your reporting requirements. The following scenarios demonstrate form completion and the expected field information in a Casino Disbursement Report based on the client’s instructions and disbursement(s) in each scenario.

Note about these scenarios

Legend for symbols used in fields
Field categories Instructions

Mandatory

These fields are indicated with an asterisk symbol (*) and must be completed.

Mandatory for processing

These fields are indicated with a double dagger symbol (‡) and must be completed. 

Mandatory if applicable

These fields are indicated with a dagger symbol (†) and must be completed if they are applicable to you or the disbursement being reported. 

In this annex

Scenario B.1: Front cash withdrawal for payout in cash

Expected field information in the report

General information – Scenario B.1
General information

Fields

Information provided by Big Money Casino

* Reporting entity number

1234567

‡ Reporting entity report reference number

CDR15137-2168517

Whom can FINTRAC contact about this report?

Information about the person at Big Money Casino that FINTRAC can liaise with in the event that a follow up is required

‡ 24-hour aggregation type

Not applicable

‡ 24-hour period start date and time

 2024-10-29T00:00:00±ZZ:ZZ

‡ 24-hour period end date and time

 2024-10-29T23:59:59±ZZ:ZZ

Disbursement information – Scenario B.1
Disbursement information
Fields Information provided for disbursement 1

* Date of disbursement

2024-10-29

* Time of disbursement

22:10:55±ZZ:ZZ

*Method of disbursement

In person

‡ Threshold indicator

Above threshold

‡ Reporting entity transaction reference number

CDR20241031-093

Information about where the disbursement was made
Fields Information provided for disbursement 1

*Reporting entity location number

567

† Street address

22 Bank Street

† City

Ottawa

† Country

Canada

† Province or state code

ON

Postal or zip code

K2S 9P9

Starting action – Scenario B.1
Starting Action
Fields Information provided for starting action 1 of disbursement 1

*Reason of disbursement

Front cash withdrawal

† Amount

11,000

† Currency

CAD

Account category

Casino account

Casino account information
Fields Information provided for starting action 1 of disbursement 1

†Casino account type

Front money

† Account number

98765

† Account currency

CAD

Date account opened

2022-06-11

Address of casino where account is held
Fields Information provided for starting action 1 of disbursement 1

†Casino identifier number where the account is held

456123

House/Building number

35

Apt/Room/Suite/Unit number

1200

† Street address

Summer Street

† City

Toronto

† Province or state code

ON

Front

Canada

Postal or zip code

L2A 7T7

Casino account holder – person
Fields Information provided for starting action 1 of disbursement 1

†Surname

Brown

† Given name

Benny

Information about the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1

† Surname

Brown

† Given name

Benny

Client number

987654

House/Building number

22

† Street address

Nation Street

† City

Ottawa

† Province or state (code)

ON

† Country

Canada

Postal or zip code

K2S 1Q1

Telephone number

613-987-6543

Email address

lastx@domain.com

† Date of birth

2000-01-01

Country of residence

Canada

† Occupation

Project manager

Name of employer

Company A

Identification information of the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1

† Identifier type

Passport

† Number associated with identifier type

AA12345678

† Jurisdiction of issue (country)

Canada

† Jurisdiction of issue (province or state) (code)

ON

On behalf of requester indicator
Fields Information provided for starting action 1 of disbursement 1

‡Was this disbursement requested on behalf of another person or entity?

No

Completing action – Scenario B.1
Completing Action
Fields Information provided for completing action 1 of disbursement 1

* Type of disbursement

Paid out in cash

† Amount

11,000

† Currency

CAD

‡ Account category

Not applicable

Involved in the completing action
Fields Information provided for completing action 1 of disbursement 1

‡Was there any other person or entity involved in the disbursement?

No

Information about the person receiving the disbursement
Fields Information provided for completing action 1 of disbursement 1

† Surname

Brown

† Given name

Benny

Client number

987654

House/Building number

22

† Street address

Nation Street

† City

Ottawa

† Province or state (code)

ON

† Country

Canada

Postal or zip code

K2S 1Q1

Telephone number

613-987-6543

Online user name

lastx@domain.com

† Date of birth

2000-01-01

Country of residence

Canada

Occupation

Project manager

Name of employer

Company A

Identification information of the person
Fields Information provided for completing action 1 of disbursement 1

Identifier type

Passport

Number associated with identifier type

AA12345678

Jurisdiction of issue (country)

Canada

Jurisdiction of issue (province or state) (code)

ON

Relationship of the person named above to the person requesting the disbursement
Fields Information provided for completing action 1 of disbursement 1

† Relationship

Self

On behalf of receiver indicator
Fields Information provided for completing action 1 of disbursement 1

‡Was this disbursement received on behalf of another person or entity?

No

Infographic summarizing scenario B.1: Front cash withdrawal for payout in cash

Illustration of the details of a casino account withdrawal for payout in cash.
Infographic summarizing scenario B.1: Front cash withdrawal for payout in cash
View text equivalent for the infographic summarizing scenario B.1

Scenario B.2: Redemption of chips on behalf of another party

Expected field information in the report

General information – Scenario B.2
General information
Fields Information provided by Big Money Casino

* Reporting entity number

1234567

‡Reporting entity report reference number

CDR15137-2168517

Whom can FINTRAC contact about this report?

Information about the person at Big Money Casino that FINTRAC can liaise with in the event that a follow up is required

‡ 24-hour aggregation type

Not applicable

‡ 24-hour period start date and time

 2024-10-29T00:00:00±ZZ:ZZ

‡ 24-hour period end date and time

 2024-10-29T23:59:59±ZZ:ZZ

Disbursement information – Scenario B.2
Disbursement information
Fields Information provided for disbursement 1

*Date of disbursement

2024-10-29

*Time of disbursement

12:10:55±ZZ:ZZ

*Method of disbursement

In person

‡ Threshold indicator

Above threshold

‡ Reporting entity transaction reference number

CDR20241031-093

Information about where the disbursement was made
Fields Information provided for disbursement 1

*Reporting entity location number

567

† Street address

 22 Bank Street

† City

 Ottawa

† Province or state (code)

 ON

† Country

 Canada

Postal or zip code

K2S 9P9

Starting action – Scenario B.2
Starting action
Fields Information provided for starting action 1 of disbursement 1

*Reason of disbursement

Redemption – chips or tokens

† Amount

25,000

† Currency

CAD

‡ Account category

Not applicable

Information about the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1

† Surname

Red

† Given name

Poppy

House/Building number

22

Apartment number

800

† Street address

Nation Street

† City

Ottawa

† Province or state (code)

ON

† Country

Canada

Postal or zip code

K2S 1Q1

Telephone number

613-987-6543

Email address

lastx@pwc.com

† Date of birth

2000-01-01

Country of residence

Canada

† Occupation

Accountant

Name of employer

Accounting A

Identification information of the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1

† Identifier type

Passport

† Number associated with identifier type

AA121381327

† Jurisdiction of issue (country)

Canada

† Jurisdiction of issue (province or state) (code)

ON

On behalf of requester indicator
Fields Information provided for starting action 1 of disbursement 1

‡ Was this disbursement requested on behalf of another person or entity?

Yes

Information about person on whose behalf the disbursement was requested
Fields Information provided for starting action 1 of disbursement 1

† Surname

Red

† Given name

Robert

Client number

34643

House/Building number

77

† Street address

Morning Street

† City

Toronto

† Country

Canada

† Province or state (code)

ON

Postal or zip code

L9S 1W1

Telephone number

647-900-8877

Email address

Robby.reddy@domain.com

Date of birth

1982-09-11

Country of residence

Canada

† Occupation

Manager

Name of employer

Accounting B

Identification information of the person on whose behalf the disbursement was requested
Fields Information provided for starting action 1 of disbursement 1

Identifier type

Driver’s licence

Number associated with identifier type

34456-45676-245

Jurisdiction of issue (country)

Canada

Jurisdiction of issue (province or state) (code)

ON

Relationship of the person on whose behalf the disbursement was requested to the person or entity requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1

† Relationship

Relative

Completing action – Scenario B.2
Completing Action
Fields Information provided for completing action 1 of disbursement 1

* Type of disbursement

Issued a cheque

† Amount

25,000

† Currency

CAD

‡ Account category

Not applicable

Involved in the completing action
Fields Information provided for completing action 1 of disbursement 1

‡ Was there any other person or entity involved in the disbursement?

No

Information about the person receiving the disbursement
Fields Information provided for completing action 1 of disbursement 1

† Surname

Red

† Given name

Poppy

Client number

987654

House/Building number

22

Apt/Room/Suite/Unit number

800

† Street address

Nation Street

† City

Ottawa

† Province or state (code)

ON

† Country

Canada

Postal or zip code

K2S 1Q1

Telephone number

613-987-6543

Email address

lastx@pwc.com

† Date of birth

2000-01-01

Country of residence

Canada

Occupation

Accountant

Name of employer

Accounting A

Identification information of the person receiving the disbursement
Fields Information provided for completing action 1 of disbursement 1

Identifier type

Passport

Number associated with identifier type

AA121381327

Jurisdiction of issue (country)

Canada

Jurisdiction of issue (province or state) (code)

ON

Relationship of the person named above to the person requesting the disbursement
Fields Information provided for completing action 1 of disbursement 1

† Relationship

Self                                                  

Relationship of the person receiving the disbursement to the person on whose behalf the disbursement is requested
Fields Information provided for completing action 1 of disbursement 1

Relationship

Relative

On behalf of receiver indicator
Fields Information provided for completing action 1 of disbursement 1

‡ Was this disbursement received on behalf of another person or entity?

Yes

Information about the person on whose behalf the disbursement was received
Fields Information provided for completing action 1 of disbursement 1

† Surname

Red

† Given name

Robert

Client number

34643

House/Building number

77

† Street address

Morning Street

† City

Toronto

† Province or state (code)

ON

† Country

Canada

Postal or zip code

L9S 1W1

Telephone number

647-900-8877

Email address

Robby.reddy@domain.com

Date of birth

1982-09-11

Country of residence

Canada

Occupation

Manager

Name of employer

Accounting B

Identification information of the person on whose behalf the disbursement was received
Fields Information provided for completing action 1 of disbursement 1

Identifier type

Driver’s licence

Number associated with identifier type

34456-45676-245

Jurisdiction of issue (country)

Canada

Jurisdiction of issue (province or state) (code)

ON

Relationship of the person on whose behalf the disbursement was received to the person receiving the disbursement
Fields Information provided for completing action 1 of disbursement 1

† Relationship

Relative

Relationship of the person on whose behalf the disbursement was received to the person requesting the disbursement
Fields Information provided for completing action 1 of disbursement 1

Relationship

Relative

Infographic summarizing scenario B.2

Illustration of the details of a redemption of chips on behalf of another party
Infographic summarizing scenario B.2: Redemption of chips on behalf of another party
View text equivalent for the infographic summarizing scenario B.2

Scenario B.3: Multiple disbursements

Expected field information in the report

General information – Scenario B.3
General information
Fields Information provided by Big Money Casino

* Reporting entity number

1234567

‡ Reporting entity report reference number

CDR15137-2168517

Whom can FINTRAC contact about this report

Information about the person at Big Money Casino that FINTRAC can liaise with in the event that a follow up is required

‡ 24-hour aggregation type

Requester

‡ 24-hour period start date and time

 2024-10-29T22:00:00±ZZ:ZZ

‡ 24-hour period end date and time

 2024-10-30T21:59:59±ZZ:ZZ

Disbursement information – Scenario B.3
Disbursement information
Fields Information provided for disbursement 1 Information provided for disbursement 2

*Date of disbursement

2024-10-29

2024-10-30

*Time of disbursement

22:59:50±ZZ:ZZ

21:00:00±ZZ:ZZ

*Method of disbursement

In person

Online

‡ Threshold indicator

Above threshold

Below Threshold

‡ Reporting entity transaction reference number

CDR20241031-093

CDR20241031-099

Information about where the disbursements were made
Fields Information provided for disbursement 1 Information provided for disbursement 2

*Reporting entity location number

567

567

† Street address

 22 Bank Street

 22 Bank Street

† City

 Ottawa

 Ottawa

† Country

 Canada

 Canada

† Province or state (code)

 ON

 ON

Postal or zip code

K2S 9P9

K2S 9P9

Starting action – Scenario B.3
Starting action
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

*Reason of disbursement

Front cash withdrawal

Front cash withdrawal

† Amount

20,000

4,000

† Currency

CAD

CAD

‡ Account category

Casino account

Casino account

Casino account information
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

†Casino account type

Front money

Front money

† Account number

98765

78765

† Account currency

CAD

CAD

Date account opened

 2022-06-11

2023-07-11

Address of casino where account is held
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

†Casino identifier number where the account is held

456123

456123

House/Building number

35

35

Apt/Room/Suite/Unit number

1200

1200

† Street address

Summer Street

Summer Street

† City

Toronto

Toronto

† Province or state (code)

ON

ON

† Country

Canada

Canada

Postal or zip code

L2A 7T7

L2A 7T7

Casino account holder –person
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

†Surname

Green

Green

† Given name

Madeline

Madeline

Information about the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

† Surname

Green

Green

† Given name

Madeline

Madeline

House/Building number

22

22

Apt/Room/Suite/Unit number

800

800

† Street address

Nation Street

Nation Street

† City

Ottawa

Ottawa

† Province or state (code)

ON

ON

† Country

Canada

Canada

Postal or zip code

K2S 1Q1

K2S 1Q1

Telephone number

613-987-6543

613-987-6543

Email address

Green@domain.com

Green@domain.com

† Date of birth

2000-01-01

2000-01-01

Country of residence

Canada

Canada

† Occupation

Accountant

Accountant

Name of employer

Company A

Company A

Identification information of the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

† Identifier type

Passport

Passport

† Number associated with identifier type

AA121381327

AA121381327

† Jurisdiction of issue (country)

Canada

Canada

† Jurisdiction of issue (province or state) (code)

ON

ON

Information about requesting the disbursement online – person
Fields Information provided for starting action 1 of disbursement 2 (does not apply to disbursement 1)

Type of device used

Mobile phone

Username

Mad.D.Green

Device identifier number

ABC59599

Internet protocol address

222.888.333

Date and time of online session in which request was made

2023-10-30
21:00:00±ZZ:ZZ

On behalf of requester indicator
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

‡Was this disbursement requested on behalf of another person or entity?

No

No

Completing action – Scenario B.3
Completing action
Fields Information provided for completing action 1 of disbursement 1 Information provided for completing action 1 of disbursement 2

* Type of disbursement

Transferred to another casino

Deposited to an account at a financial institution

†Amount

20,000

4,000

†Currency

CAD

CAD

‡ Account category

Casino account

Financial institution account

Casino account information – completing action
Fields Information provided for completing action 1 of disbursement 1 (does not apply to disbursement 2)

†Casino account type

Front money

† Account number

78765

† Account currency

CAD

Date account opened

2023-07-11

Address of casino where account is held
Fields Information provided for completing action 1 of disbursement 1 (does not apply to disbursement 2)

†Casino identifier number where the account is held

956127

House/building number

15

Apt/Room/Suite/Unit number

1000

† Street address

Front Street

† City

Toronto

†Province or state code

ON

† Country

Canada

Postal or zip code

L2A 7T8

Casino account holder – person
Fields Information provided for completing action 1 of disbursement 1 (does not apply to disbursement 2)

†Surname

Green

† Given name

Madeline

Financial institution account information – completing action
Fields Information provided for completing action 1 of disbursement 1 (does not apply to disbursement 2)

† Account type

Personal

† Financial institution number

10

† Branch number

231667

† Account number

9876543

† Account currency

CAD

Date account opened

2000-21-03

Financial institution account holder – person
Fields Information provided for completing action 1 of disbursement 1 (does not apply to disbursement 2)

†Surname

Green

† Given name

Madeline

Involved in the completing action
Fields Information provided for completing action 1 of disbursement 1 Information provided for completing action 1 of disbursement 2

‡ Was there any other person or entity involved in the disbursement?

No

No

Information about the person receiving the disbursement
Fields Information provided for completing action 1 of disbursement 1 Information provided for completing action 1 of disbursement 2

† Surname

Green

Green

† Given name

Madeline

Madeline

House/Building number

22

22

Apt/Room/Suite/Unit number

800

800

† Street address

Nation Street

Nation Street

† City

Ottawa

Ottawa

† Province or state (code)

ON

ON

† Country

Canada

Canada

Postal or zip code

K2S 1Q1

K2S 1Q1

Telephone number

613-987-6543

613-987-6543

Email address

Green@domain.com

Green@domain.com

† Date of birth

2000-01-01

2000-01-01

Country of residence

Canada

Canada

Occupation

Accountant

Accountant

Name of employer

Company A

Company A

Identification information of the person receiving the disbursement
Fields Information provided for completing action 1 of disbursement 1 Information provided for completing action 1 of disbursement 2

Identifier type

Passport

Passport

Number associated with identifier type

AA121381327

AA121381327

Jurisdiction of issue (country)

Canada

Canada

Jurisdiction of issue (province or state) (code)

ON

ON

Relationship of the person receiving the disbursement to the person or entity requesting the disbursement
Fields Information provided for completing action 1 of disbursement 1 Information provided for completing action 1 of disbursement 2

† Relationship

Self                                                  

Self                                                  

On behalf of receiver indicator
Fields Information provided for completing action 1 of disbursement 1 Information provided for completing action 1 of disbursement 2

‡ Was this disbursement received on behalf of another person or entity?

No

No

Infographic summarizing scenario B.3

Infographic summarizing scenario B.3: Multiple disbursements
View text equivalent for the infographic summarizing scenario B.3

Scenario B.4: Multiple disbursements

Expected field information in the report

General information – Scenario B.4
General information
Fields Information provided by Big Money Casino

* Reporting entity number

1234567

‡ Reporting entity report reference number

CDR15137-2168517

Whom can FINTRAC contact about this report?

Information about the person at Big Money Casino that FINTRAC can liaise with in the event that a follow up is required

‡ 24 hour aggregation type

Requester

‡ 24-hour period start date and time

 2024-10-29T22:00:00±ZZ:ZZ

‡ 24-hour period end date and time

 2024-10-29T21:59:59±ZZ:ZZ

Disbursement information – Scenario B.4
Disbursement information
Fields Information provided for disbursement 1 Information provided for disbursement 2

*Date of disbursement

2024-10-29

2024-10-30

*Time of disbursement

22:59:50±ZZ:ZZ

21:00:00±ZZ:ZZ

*Method of disbursement

In person

In person

‡ Threshold indicator

Below threshold

Below threshold

‡ Reporting entity transaction reference number

CDR20241031-093

CDR20241031-099

Information about where the disbursements were made
Fields Information provided for disbursement 1 Information provided for disbursement 2

*Reporting entity location number

567

561

† Street address

 22 Bank Street

21 First Street

† City

 Ottawa

Ottawa

† Country

 Canada

Canada

† Province or state (code)

 ON

ON

Postal of zip code

K2S 9P9

K2S 9P8

Starting action – Scenario B.4
Starting action
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

*Reason of disbursement

Redemption – chips

Redemption - slot tickets

† Amount

8,000

3,000

† Currency

CAD

CAD

‡ Account information type

Not applicable

Not applicable

Information about the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

† Surname

Blue

Blue

† Given name

Sam

Sam

Apt/Room/Suite/Unit number

600

600

House/Building number

22

22

† Street address

Nation Street

Nation Street

† City

Ottawa

Ottawa

† Country

Canada

Canada

† Province or state (code)

ON

ON

Postal or zip code

K2S 1Q1

K2S 1Q1

Telephone number

613-987-6543

613-987-6543

Email address

Blue@domain.com

Blue@domain.com

† Date of birth

1980-01-01

1980-01-01

Country of residence

Canada

Canada

† Occupation

Accountant

Accountant

Name of employer

Company A

Company A

Identification information of the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

† Identifier type

Passport

Passport

† Number associated with identifier type

AA121381327

AA121381327

† Jurisdiction of issue (country)

Canada

Canada

† Jurisdiction of issue (province or state) (code)

ON

ON

On behalf of requester indicator
Fields Information provided for starting action 1 of disbursement 1 Information provided for starting action 1 of disbursement 2

‡Was this disbursement requested on behalf of another person or entity?

No

Yes

Information about the entity on whose behalf the disbursement was requested
Fields Information provided for starting action 1 of disbursement 2 (does not apply to disbursement 1)

† Name of entity

Kitchen Supply Company Inc.

House/Building number

11

† Street address

Yonge Street

† City

Toronto

† Country

Canada

† Province or state (code)

ON

Postal or zip code

L9S 1W1

Telephone number

647-900-8877

Email address

KitchenSupply@domain.com

† Nature of entity’s principal business

Kitchen supplies

‡ Do you have incorporation or registration information?

Yes

† Is the entity incorporated or registered?

Incorporated

Incorporation information of the entity on whose behalf the disbursement was requested
Fields Information provided for starting action 1 of disbursement 2 (does not apply to disbursement 1)

† Incorporation number

875234

† Jurisdiction of issue (country) of incorporation

Canada

† Jurisdiction of issue (province or state) (code) of incorporation

ON

Identification information of the entity on whose behalf the disbursement was requested
Fields Information provided for starting action 1 of disbursement 2 (does not apply to disbursement 1)

Identifier type

Certificate of incorporation

Number associated with identifier type

A4567223

Jurisdiction of issue (country)

Canada

Jurisdiction of issue (province or state) (code)

ON

Person authorized to bind the entity on whose behalf the disbursement was requested or act with respect to the account
Fields Information provided for starting action 1 of disbursement 2 (does not apply to disbursement 1)

Surname

Blue

Given name

Sam

Relationship of the entity on whose behalf the disbursement was requested to the person requesting the disbursement
Fields Information provided for starting action 1 of disbursement 2 (does not apply to disbursement 1)

†Relationship

Legal counsel

Completing action – Scenario B.4
Completing action
Fields Information provided for completing action 1 of disbursement 1 Information provided for completing action 1 of disbursement 2

* Type of disbursement

Paid out in cash

Sent domestic funds transfer

† Amount

8,000

3,000

† Currency

CAD

CAD

‡ Account category

Not applicable

Financial institution account

Financial institution account information
Fields Information provided for completing action 1 of disbursement 2 (does not apply to disbursement 1)

† Account type

Business

† Financial institution number

10

† Branch number

231667

† Account number

9876543

† Account currency

CAD

Date account opened

2000-03-21

Financial institution account holder – entity
Fields Information provided for completing action 1 of disbursement 2 (does not apply to disbursement 1)

†Name of entity

Kitchen Supply Company

Involved in the completing action
Fields Information provided for completing action1  of disbursement 1 Information provided for completing action 1 of disbursement 2

‡Was there any other person or entity involved in the disbursement?

Yes

No

Other person involved in the completing action
Fields Information provided for completing action of disbursement 1 (does not apply to disbursement 2)

†Surname

Yellow

† Given name

Yara

† Account number

435678

Information about the person receiving the disbursement
Fields Information provided for completing action of disbursement 1 (does not apply to disbursement 2)

† Surname

Blue

† Given name

Sam

Apt/Room/Suite/Unit number

600

House/Building number

22

† Street address

Nation Street

† City

Ottawa

† Country

Canada

† Province or state (code)

ON

Postal or zip code

K2S 1Q1

Telephone number

613-987-6543

Email address

Blue@domain.com

† Date of birth

1980-01-01

Country of residence

Canada

Occupation

Accountant

Name of employer

Company A

Identification information of the person receiving the disbursement
Fields Information provided for completing action of disbursement 1 (does not apply to disbursement 2)

Identifier type

Passport

Number associated with identifier type

AA121381327

Jurisdiction of issue (country)

Canada

Jurisdiction of issue (province or state) (code)

ON

Relationship of the person receiving the disbursement to the person requesting the disbursement
Fields Information provided for completing action of disbursement 1 (does not apply to disbursement 2)

†Relationship

Self

Information about the entity receiving the disbursement
Fields Information provided for completing action 1 of disbursement 2 (does not apply to disbursement 1)

† Name of entity

Kitchen Supply Company Inc.

House/Building number

11

† Street address

Yonge Street

† City

Toronto

† Country

Canada

† Province or state (code)

ON

Postal or zip code

L9S 1W1

Telephone number

647-900-8877

Email address

KitchenSupply@domain.com

† Nature of entity’s principal business

Kitchen Supplies

‡ Do you have incorporation or registration information?

Yes

Is the entity incorporated or registered?

Incorporated

Incorporation information of the entity receiving the disbursement
Fields Information provided for completing action 1 of disbursement 2 (does not apply to disbursement 1)

Incorporation number

875234

Jurisdiction of issue (country) of incorporation

Canada

Jurisdiction of issue (province or state) (code) of incorporation

ON

Identification information of the entity receiving the disbursement
Fields Information provided for completing action 1 of disbursement 2 (does not apply to disbursement 1)

Identifier type

Certificate of incorporation

Number associated with identifier type

A4567223

Jurisdiction of issue (country)

Canada

Jurisdiction of issue (province or state) (code)

ON

Person authorized to bind the entity receiving the disbursement or act with respect to the account
Fields Information provided for completing action 1 of disbursement 2 (does not apply to disbursement 1)

Surname

Blue

Given name

Sam

Relationship of the entity receiving the disbursement to the person requesting the disbursement
Fields Information provided for completing action 1 of disbursement 2 (does not apply to disbursement 1)

†Relationship

Employer

Relationship of the entity receiving the disbursement to the person on whose behalf the disbursement was requested
Fields Information provided for completing action 1 of disbursement 2 (does not apply to disbursement 1)

Relationship

Self

On behalf of receiver indicator
Fields Information provided for completing action of disbursement 1 Information provided for completing action of disbursement 2

‡ Was this disbursement received on behalf of another person or entity?

No

No

Infographic summarizing scenario B.4

llustration of details of multiple disbursements
Infographic summarizing scenario B.4: Multiple disbursements
View text equivalent for the infographic summarizing scenario B.4

For assistance

If you have questions about this guidance, please contact FINTRAC by email at guidelines-lignesdirectrices@fintrac-canafe.gc.ca.

Date Modified: