Customer Suspicious Matter Report (SMR)

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07 5524 3655
4 Minjungbal Dr, Tweed Heads South

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Please fill out the form below for any suspicous matters you may notice in the gaming area.

Be as specific as possible

You can upload photos toward the end of the form if required

Gaming Suspicious Matter (SMR) form

"*" indicates required fields

Step 1 of 9

11%

Please notify a supervior and let them know you are completing this SMR form

Date*

DD dash MM dash YYYY

Time of report

Hours

Minutes

Staff Member Name who is lodging the form:*

Customer details

Customer Name if known

Member number (if known)

Desription of the individual if name and details are unknown

Did the customer provide ID?

Customer ID (If available)

ID type..

Drivers licence

Passport

Pension card

Proof of age card

Other

other details

State of issue

Document number

Nationality

Address

Street Address City State / Province / Region ZIP / Postal Code Country

SMR Details

Date of suspicious incident*

DD slash MM slash YYYY

Time of incident

Hours

Minutes

Service type

Gaming

TAB

KENO

Cashier

Other

Approximate amount

less than $1,000

$1,000 - $4,999

$5,000 - $9,999

$10,000+

Location of suspicious incident

What suspicion indicators where observed? (tick all that apply)

Multiple linked transactions

Cash in - minimal play - cash out

Refusal to provide ID

Multiple machines used

Request to avoid reporting

Third-party involvement

Rapid movement between machines

Refused to answer questions

Nervous / evasive behaviour

Multiple people linked to one gaming activity (smurfing)

possible use of proceeds of crime

Customer appears to be avoiding staff observation

Other (describe below with other details)

Describe the suspicious activity

Immediate Actions Taken

Requested customer ID

Refused transactions

Transaction completed for safety reasons

Player activity reviewed

Escalated to Supervisor or Manager

Compliance Officer notified

Police called

No Action

Other (describe below with other details)

Describe the action taken

Any other information you wish to include:

Press select files to take a photo or upload a photo from your phone if required

Drop files here or

Max. file size: 2 MB.

Was there any CCTV of the event?

Yes

Details of CCTV. Time, date, camera etc...

Was gaming data reviewed?

Yes

Details of gaming data

Press select files to take a photo or upload a photo from your phone if required

Drop files here or

Max. file size: 2 MB.

Were any witness statements obtained

Yes

Witness name

Witness contact deatils (phone or email)

Witness statement

Staff declaration

I confirm that the information in this report is true and accurate to the best of my knowledge and has been recorded factually*

I confirm this information

Name

First Last

Submit

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07 5524 3655

4 Minjungbal Dr, Tweed Heads South

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South Tweed Sports

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Home Page
Bar & Dining
- Restaurant
- The Cafe
What’s On
- Entertainment
- What’s On
Sports
- Bowls
- Sports
- Game On
Functions
Membership
- Membership Sign Up
- Membership Renewal
Our Club
Courtesy Bus
- Courtesy Bus

07 5524 3655
4 Minjungbal Dr, Tweed Heads South

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