Get Application For Statewide Self-exclusion - Mgc Dps Mo

The Application For Statewide Self-Exclusion is an important document for individuals seeking to exclude themselves from gambling activities in Missouri. This guide provides a step-by-step approach to help users complete the form effectively and accurately.

Follow the steps to complete the application with ease

1. Click ‘Get Form’ button to retrieve the form and open it in the editor.
2. Read the instructions thoroughly, including the Voluntary Self-Exclusion Program Rules and guidelines, before filling out any information.
3. Begin with Section 1: Personal Information. Fill in your full legal name, address, and contact details. Be sure to include a recent photo and a copy of your government-issued identification card.
4. Complete the gender, date of birth, and Social Security Number or other identification number fields as applicable. Disclosure of your Social Security Number is voluntary but may aid processing.
5. Continue with the remaining questions in Section 1, including other names used, noticeable physical characteristics, employment details, and reasons for seeking self-exclusion. Ensure to answer all sections accurately.
6. Review Section 2, which contains the List of Disassociated Persons Self-Exclusion Guidelines. Familiarize yourself with the requirements and responsibilities associated with your self-exclusion.
7. Move to Section 3: Waiver and Release, and read carefully to understand the implications of releasing claims against the Missouri Gaming Commission and related entities.
8. Sign and date the acknowledgment and signature section in Section 4, certifying the truthfulness of your application. This signature must be witnessed by an authorized Missouri Gaming Commission agent.
9. Ensure the application is complete and presents accurate information. Submit the form as instructed and keep a copy for your records.

Complete your application for self-exclusion online today to take a step towards managing your gambling activities.