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REQUEST FOR VOLUNTARY SELFEXCLUSION FROM ALL GAMING FACILITIES AND ENTITIES LICENSED, PERMITTED OR REGISTERED BY THE NEW YORK STATE GAMING COMMISSION THIS FORM IS TO BE COMPLETED BY THE PERSON WHO

How to fill out request for voluntary self-exclusion

How to fill out request for voluntary self-exclusion

1. To fill out a request for voluntary self-exclusion, follow these steps:
2. Download the request form from the official website or obtain it from a relevant authority.
3. Fill in your personal details, such as your full name, address, and contact information.
4. Provide your reasons for requesting voluntary self-exclusion.
5. Indicate the duration of the self-exclusion period, whether it is temporary or indefinite.
6. Review the terms and conditions of the voluntary self-exclusion program.
7. Sign and date the form to acknowledge your understanding and agreement.
8. Submit the completed form to the designated authority or organization.
9. Keep a copy of the completed form for your records.
10. If required, attend any necessary meetings or counseling sessions as part of the self-exclusion program.
11. Follow the guidelines and restrictions outlined by the self-exclusion program to ensure its effectiveness.

Who needs request for voluntary self-exclusion?

1. Anyone who wishes to take a break or restrict their access to certain gambling activities can make use of the request for voluntary self-exclusion. This can include individuals who feel they have a gambling problem or those who simply want to limit their gambling activities for a period of time. Voluntary self-exclusion is a proactive step for individuals who want to regain control over their gambling habits or take responsibility for their actions. It is a tool available for those who recognize the need to temporarily or permanently exclude themselves from participating in gambling activities.

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What is request for voluntary self-exclusion?

Request for voluntary self-exclusion is a formal process in which an individual requests to be excluded from gambling activities at a specific establishment or online platform for a certain period of time.

Who is required to file request for voluntary self-exclusion?

Any individual who wishes to restrict their access to gambling activities is required to file a request for voluntary self-exclusion.

How to fill out request for voluntary self-exclusion?

To fill out a request for voluntary self-exclusion, an individual needs to provide their personal information, specify the duration of the exclusion period, and sign the form to acknowledge their agreement to the terms.

What is the purpose of request for voluntary self-exclusion?

The purpose of request for voluntary self-exclusion is to help individuals control their gambling habits and prevent compulsive behavior by restricting their access to gambling activities.

What information must be reported on request for voluntary self-exclusion?

The request for voluntary self-exclusion must include the individual's full name, contact information, identification number, requested exclusion period, and signature.