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- Click ‘Get Form’ to open the nj self exclusion form in the editor.
- Begin by filling in your last name, first name, and middle name in the designated fields. Ensure accuracy as this information is crucial for identification.
- Enter your date of birth, height, weight, and contact numbers. Providing a daytime or work telephone number is essential for any follow-up communication.
- If applicable, include your social security number. Remember that disclosing this information is voluntary and will not affect your request if omitted.
- Complete your home address and mailing address if different. This ensures that all correspondence reaches you promptly.
- Indicate if you have been known by any other names. If yes, list them along with the dates of use.
- Finally, review all entered information for accuracy before signing and dating the acknowledgment section at the bottom of the form.
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