Request for self-exclusion
Source version current through Mar 31, 2022
Source details
- NYCRR title agency
- Executive Department
- Section status
- Section source receipt
- Source version current through
- Mar 31, 2022
- Text saved
- Sep 13, 2026
- Publisher current-through date
- Mar 31, 2022
- Source captured
- Sep 13, 2026
- Stored text comparison
- Matches the captured source text
- Related Register notice
- SGC-47-18-00009-A · Adopted rule
- Related notice published
- Apr 10, 2019
- Related notice effective date
- Apr 10, 2019
(a)A person requesting placement on the self-exclusion list shall submit to the commission or the commission’s designee a completed request for voluntary self-exclusion form provided by the commission. Such submission may be made by appearing at the commission’s principal office in Schenectady during regular business hours or at any licensed gaming facility’s area designated for problem gambling intake. Persons who are unable to travel may request accommodation for submission through United States mail, so long as a notarized statement accompanies the required form stating clearly that the person signing understands fully the implications of submitting such form.
(b)A request for self-exclusion from gaming activities shall include the following identifying information:
(1)name, including any aliases or nicknames;
(2)date of birth;
(3)address of current residence;
(4)telephone number;
(5)social security number, when voluntarily provided in accordance with section seven of the Privacy Act of 1974 (5 U.S.C. section 552a) or article 6-A of the Public Officers Law (Personal Privacy Protection Law);
(6)a copy of a current government-issued photo identification, such as a driver’s license or passport; and
(7)height, weight, gender, hair color, eye color and any other physical characteristic that may assist in the identification of the person.
(c)Any person requesting self-exclusion pursuant to this Part shall be required to file with the commission or the commission’s designee a photograph of such person taken within six months of the date of the request. Such photograph shall accompany the submission of the required form.
(d)A self-excluded person shall update any of the information set forth in paragraphs of (b)(1) through (6) of this section and any material change in any of the information set forth in paragraph (b)(7) of this section within 30 days of any change.
(e)The length of self-exclusion requested by a person shall be one of the following:
(1)one year;
(2)three years;
(3)five years; or
(4)lifetime.
(f)The commission or the commission’s designee shall document a description of the type of identification credentials examined containing the signature of a person requesting self-exclusion and whether said credentials included a photograph or general physical description of the person.
(g)The commission or the commission’s designee shall document the signature of the intake employee authorized to accept a self-exclusion request, indicating that the signature of the person on the request for self-exclusion appears to agree with that contained on the requester’s identification credentials and that any photograph or physical description of the person appears to agree with the requester’s actual appearance.
(h)Each person requesting self-exclusion shall be advised in writing that if such person is found violating the rules set forth in this Part, such person may be subject to arrest for trespassing pursuant to Penal Law sections 140.10, 140.15 and 140.17.