Remote self-exclusion authority and identification form

URL: https://www.publications.qld.gov.au/dataset/5b743aff-7852-41c4-ab03-a83464d6f681/resource/dbeb01f5-03ed-4ea7-864a-dbd871f7cfae/download/remote-self-exclusion-form-v3c.pdf

Complete this form to authorise the Gambling Help service to act as your representative when consenting to seek a remote self-exclusion from a gaming venue.

Additional Information

Field Value
Data last updated 26 June 2020
Metadata last updated 26 June 2020
Created 26 June 2020
Format PDF
License Creative Commons Attribution 3.0
Expiration date26/06/2021
Used in data-driven applicationNO
Approvalno
BannerNone
Has viewsFalse
Iddbeb01f5-03ed-4ea7-864a-dbd871f7cfae
Mimetypeapplication/pdf
Package id5b743aff-7852-41c4-ab03-a83464d6f681
Position11
Size138.4 KiB
Stateactive
Url typeupload