Get Self-restriction Form - Cgcc-036 - California Gambling Control ... - Cgcc Ca

Filling out the Self-Restriction Form - CGCC-036 is an important step for individuals seeking to limit their access to gambling activities in California. This guide will provide you with clear, step-by-step instructions to help you complete the form effectively and efficiently.

Follow the steps to fill out the Self-Restriction Form correctly.

1. Click ‘Get Form’ button to obtain the form and open it in your browser.
2. Begin with Section 1, which requires your personal information. Fill in your full legal name, including first, middle (if applicable), and last name. Provide any other names you have used, such as maiden names or aliases. Next, enter your home address, including street, city, state, and zip code, as well as a mailing address if it differs from your home address. Finally, provide your home and business telephone numbers, and indicate the games you most frequently play.
3. Proceed to Section 2, where you will specify your restriction preferences. Indicate the name of the cardroom or participating gambling facility. Choose the total exclusion term by marking the appropriate option: one year, five years, or a lifetime. You can also request to be removed from marketing materials and restrict various gambling privileges. Clearly indicate if you wish to limit certain privileges and provide detailed specifications as necessary.
4. In Section 3, provide your gender, height, weight, date of birth, race/ethnicity, hair color/type, and eye color. Attach a recent passport-quality photograph showing your head and shoulders in the designated area. Complete your California driver’s license number and describe any distinguishing marks, such as visible scars or tattoos.
5. Section 4 is for the declaration. Acknowledge your understanding of the form and confirm you seek to exclude yourself voluntarily. Initial each statement that applies to your total exclusion choices and understand your responsibilities regarding the restrictions. Sign and print your name and date the declaration.
6. If necessary, Section 5 is for notarization or witness affirmation. Ensure a notary public or key employee from the establishment witnesses your completion of the form to authenticate it.
7. Once all sections are completed and verified, save any changes you have made to the document. You can choose to download, print, or share the form as needed.

Take the first step towards managing your gambling activities by filling out the Self-Restriction Form online today.