Follow the steps to fill out the OH CCC Request For Removal Form online effectively.

1. To get started, click the ‘Get Form’ button to access the form. This will allow you to open it in your preferred online editor.
2. Carefully read the entire form and the attached removal guidelines to understand the process before filling out any sections.
3. Provide your full legal name in Section 1. This includes your first name, middle initial, and last name.
4. If you have any aliases, nicknames, or previous names, list them in the designated field in Section 1.
5. In Section 1, fill in your residential address, including street or P.O. Box, city, state, zip, and county of residence.
6. Enter your residential and other telephone numbers in Section 1. Ensure that these numbers are active and accessible.
7. Complete Section 1 by providing your Social Security Number. Note that under the Privacy Act, disclosure is voluntary.
8. In Section 1, enter your date of birth, driver’s license or state identification number, and the date you enrolled in the Voluntary Exclusion Program.
9. Proceed to Section 2 to sign the waiver and release. This section involves acknowledging that you understand the implications of your removal request.
10. In Section 3, acknowledge that the information provided is accurate, and sign to confirm your request for removal. Ensure you include the date and time of signing.
11. If applicable, complete Section 4 for interpreter information, including full details about the interpreter and their affirmation.
12. After completing all sections, review your form for accuracy. Once satisfied, save your changes, and you may then download, print, or share the form as needed.

Start your removal process now by completing the OH CCC Request For Removal Form online.