Gambling exclusion forms

Data and Resources

• Form 3A - Self-exclusion notice PDF

  Individuals seeking to self-exclude from a venue or gambling activity must...

• Form 3B - Self-exclusion order PDF

  On receipt of Form 3A, the gambling provider completes Form 3B and gives it...

• Form 3C - Revocation notice - self-exclusion order PDF

  Individuals seeking to cancel self-exclusion must complete form 3C and lodge...

• Form 3D - Exclusion direction PDF

  The gambling provider completes Form 3D and gives it to the individual to...

• Form 3E - Application to revoke exclusion direction PDF

  Individuals seeking to cancel venue-initiated exclusion must complete form 3E...

• Form 3F - Revocation notice exclusion direction PDF

  On receipt of Form 3E, the gambling provider completes Form 3F and gives it...

• Form 3G - Register of excluded persons PDF

  The gambling provider record the details of individuals who have been...

• Form 3H - Notice of contravention of self-exclusion order / exclusion direction PDF

  The gambling provider completes Form 3H if an individual breaches a self-...

• Form 3I - Information notice exclusion direction PDF

  The gambling provider completes Form 3I and gives it to the individual with...

• Form 3J - Information notice refusal to revoke an exclusion direction PDF

  On receipt of Form 3E, the gambling provider completes Form 3J and gives it...

• Form 3R - Report on excluded persons PDF

  The gambling provider completes Form 3R and lodges it with the Office of...

• Remote self-exclusion authority and identification form PDF

  Complete this form to authorise the Gambling Help service to act as your...

• Step by step remote self-exclusions guide for Gambling Help Services PDF

  Gambling Help services should follow this guide to help a person remotely...

• Test form PDF

  Test form