Get the free 5 Years Self Exclusion NG form.final.docx

Livelier SelfExclusion File # Date Name PC Card # Street City/Town State Zip DOB Soc. Sec. # Vehicle Reg. # State Make Model Color Please initial lines below:I hereby request that I be banned from

How to fill out 5 years self exclusion

How to fill out 5 years self exclusion

1. Locate the self-exclusion form: Most gambling establishments will have a self-exclusion form available on their website or at their physical location.
2. Fill out personal information: Provide your full name, date of birth, contact information, and any other required details as stated in the form.
3. Specify exclusion duration: Select the option for a 5 years self-exclusion period on the form.
4. Sign and date the form: Once you have filled out all the necessary information, sign and date the form to acknowledge your intent for self-exclusion.
5. Submit the form: Send or submit the completed form to the appropriate contact or department as specified by the gambling establishment.
6. Follow up: It's recommended to follow up with the gambling establishment to ensure the self-exclusion request has been successfully processed.

Who needs 5 years self exclusion?

1. Anyone who recognizes that they have a gambling addiction or problem and wishes to take active measures to prevent themselves from engaging in further gambling activities.

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What is 5 years self exclusion?

5 years self exclusion is a voluntary program that allows individuals to exclude themselves from gambling for a period of five years.

Who is required to file 5 years self exclusion?

Individuals who have a gambling addiction or those who want to take a break from gambling are required to file for 5 years self exclusion.

How to fill out 5 years self exclusion?

To fill out 5 years self exclusion, individuals can contact their local gambling regulatory agency or visit their website to submit the necessary forms.

What is the purpose of 5 years self exclusion?

The purpose of 5 years self exclusion is to help individuals with gambling addiction by providing a period of time where they cannot engage in gambling activities.

What information must be reported on 5 years self exclusion?

Individuals must provide their personal information, including name, contact details, and any relevant gambling history when filing for 5 years self exclusion.