Client Application

Apply for an account.

This form takes about ten minutes. It asks for your identity, your financial position and how you bet — all three are needed before we can properly assess an application, and all three are required of us by law. Mark and Mitchell read every submission personally.

How your information is handled

Everything you enter is transmitted over an encrypted connection and used solely to verify your identity, assess this application, and meet our obligations under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006 and our Victorian bookmaker's licence. It is not sold, not used for marketing, and not disclosed to any third party except where the law compels it. If your application is unsuccessful, your data is retained only for the period the law requires and is then destroyed. See our Privacy Policy.

Step 1 of 6 · You

1 · You 2 · Address 3 · Financial 4 · Betting 5 · Declarations 6 · Review

Applicant details

Enter your name exactly as it appears on your government-issued identification. A mismatch is the most common reason an application stalls.

Legal first name *

Middle name(s)

Legal surname *

Preferred name

Date of birth *

You must be 18 or over.

Mobile *

Email *

Which document will you verify with? *

We check these details against the issuing authority. You do not need to send us a scan or a photo — just the details printed on the card.

Australian driver licence Australian passport

I can also provide a Medicare card. Adding a second document usually gets an application verified faster.

Citizenship / residency status *

Residential address

We're required to verify a current residential address. A PO box cannot be used for this purpose, though you can give one separately for post.

Street address *

Suburb *

State *

Postcode *

Time at this address *

Postal address — if different

Financial position

We keep this section as short as the law allows. Our licence requires us to understand where your betting funds come from and to form a reasonable view that your betting is affordable — so that is all we ask. No employment details, no income figures, no statement of assets.

Source of the funds you intend to bet with *

Select all that apply.

Tell us a little more about that source *

A sentence or two is enough. This is the single most useful answer on the form for us.

Amount you could comfortably lose in a year without it affecting your circumstances *

Answer this honestly rather than optimistically. A conservative answer does not count against an application — an unrealistic one does.

Anything else about your financial position we should know

How you bet

This tells us whether our book is a fit for yours. There are no right answers here — a modest, steady punter is as welcome as a heavy one.

Responsible gambling & declarations

Two questions and a short set of declarations. Answering yes to either question does not automatically end an application — but an inaccurate answer will.

Are you currently registered with BetStop, the National Self-Exclusion Register? *

If you are currently registered, we are prohibited by law from opening an account for you and will not be able to proceed. You can check your status at betstop.gov.au.

Have you ever self-excluded from, or been excluded by, a wagering operator or venue? *

Would you like a deposit limit set on your account from day one?

You can add, reduce or remove a limit at any time. Reductions take effect immediately; increases are subject to a cooling-off period.

Before you sign

Gambling is entertainment, not a way to make money, and the odds are structured so that most people lose over time. If betting has ever caused you or someone close to you difficulty, please don't submit this form.

Free and confidential support is available on 1800 858 858, 24 hours a day, or at gamblinghelponline.org.au.

I confirm that I am 18 years of age or older. The information I have provided is true, accurate and complete to the best of my knowledge. I understand that providing false information may result in my application being refused or an account being closed. I consent to Sampieri Racing verifying my identity, address and the information in this application, including through third-party verification services, as required under the Anti-Money Laundering and Counter-Terrorism Financing Act 2006. I am applying on my own behalf, with my own funds, and not on behalf of any other person. I have read and accept the Privacy Policy and the Terms & Conditions, and I understand that submitting this form does not create an account or guarantee that one will be offered. Optional — I'd like to receive occasional updates from Sampieri Racing. You can unsubscribe at any time, and leaving this unticked has no bearing whatsoever on your application.

Review & submit

Check everything below, then submit. You'll receive an acknowledgement by email with a reference number.

✓

Application received.

Thank you — it's with us. Mark and Mitchell review every application personally, and you'll hear back either way, usually within three to five business days.

We verify the document details you gave us directly with the issuing authority. If anything doesn't match, we'll call you — we won't ask you to email us a scan.

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Chances are you're about to lose.

18+Set a deposit limit. For free and confidential support call 1800 858 858 or visit gamblinghelponline.org.au. National self-exclusion: betstop.gov.au.