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Self-Exclusion Notice Front View (compulsory) Profile (optional) Attach passport size photo here Attach passport size photo here Self-Exclusion Notice Section 1: Details of person seeking exclusion
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How to fill out self-exclusion notice - department
How to fill out self-exclusion notice - department:
01
Obtain the self-exclusion notice form from the department. This form is typically available online or can be obtained directly from the department's office.
02
Fill out your personal information accurately. Provide your full name, contact details, and any other information required by the form. Make sure to double-check your information for accuracy before proceeding.
03
Indicate the duration of the self-exclusion. Specify the length of time you wish to be excluded from the department's services or facilities. This can range from a few months to several years, depending on your preferences.
04
Sign and date the form. By signing the self-exclusion notice, you acknowledge your understanding of the terms and conditions. Make sure to include the date of when you filled out the form.
05
Submit the form to the department. Follow the instructions provided to submit the self-exclusion notice. This can involve mailing the form, dropping it off in person, or submitting it online, depending on the department's procedures.
Who needs self-exclusion notice - department:
01
Individuals who wish to voluntarily exclude themselves from the department's services or facilities for a specific period of time.
02
People who are struggling with addiction or gambling-related concerns and want to take proactive steps to prevent further involvement.
03
Those who have recognized that their behavior or usage of the department's services has become problematic and want to limit or avoid access for a designated period.
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What is self-exclusion notice - department?
Self-exclusion notice - department is a form that allows an individual to exclude themselves from participating in certain activities or services provided by a particular department.
Who is required to file self-exclusion notice - department?
Any individual who wishes to self-exclude themselves from department activities or services is required to file a self-exclusion notice.
How to fill out self-exclusion notice - department?
The self-exclusion notice typically requires the individual to provide their personal information, reason for self-exclusion, and signature.
What is the purpose of self-exclusion notice - department?
The purpose of the self-exclusion notice is to allow individuals to voluntarily exclude themselves from department services or activities for a specified period of time.
What information must be reported on self-exclusion notice - department?
The self-exclusion notice may require information such as the individual's name, contact information, reason for self-exclusion, and signature.
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