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FORMS
NOTE: EFFECTIVE AS OF
MONDAY, DECEMBER 19, 2011
Note: "Yellow" indicates fillable form.
EMPLOYEE CREDENTIAL
Form #
Document Name
1
Personal History Disclosure Form 3 - Casino Employee Registration
2
Casino Employee License Conversion Application
3
Request to Determine Employment or Reapplication Eligibility
4
License Application Request Form
5
(And 43 And 63)
Credit Card Authorization
6
Change of Name or Address Form
7
Request for Copy of Registration Credential
8
Notice of Right to Division Hearing
9
Link to Right to Appeal to Casino Control Commission
10
Temporary Casino Key Employee Licensure
CASINO LICENSE
Form #
Document Name
20
(And 32)
Multi-Jurisdictional Personal History Disclosure Form
21
New Jersey Supplemental Form to the Multi-Jurisdictional Personal History Disclosure Form - Casino Qualifiers and Casino Key Employee Qualifiers
22
Personal History Disclosure Resubmission Form - Casino Qualifiers
23
Business Entity Disclosure Form - Casino Company and Casino Holding and Intermediary Company
24
(And 37)
Institutional Investor Certification
25
Personal History Disclosure Form 1 - Casino Qualifiers
ENTERPRISE LICENSE
Form #
Document Name
30
Instructions for Filing an Application for a Casino Service Industry Enterprise License
30A
Instructions for Filing an Application for an Ancillary Casino Service Industry Enterprise License
31
Business Entity Disclosure Form - Casino Service Industry Enterprise License
31A
Business Entity Disclosure Form - Ancillary Casino Service Industry Enterprise License
32
(And 20)
Multi-Jurisdictional Personal History Disclosure Form
32A
Personal History Disclosure Form - Ancillary Casino Service Industry Enterprise
33
New Jersey Supplemental Form to the Multi-Jurisdictional Personal History Disclosure Form - Casino Service Industry Enterprise Qualifiers
34
Personal History Disclosure Form 2 - Outside Directors of Holding and Intermediary Companies of Casino Service Industry Enterprises
35
Casino Service Industry Enterprise - Qualifier Resubmission Disclosure Form
36
(And 56)
Equal Opportunity and Affirmative Action Obligations - Casino Service Industry Applicants/Licensees
37
(And 24)
Institutional Investor Certification
38
Labor Organization Registration Statement
39
Labor Organization Individual Disclosure Form
40
Vendor Registration Form -
Contact the casino you are doing business with for this form.
41
Vendor Registration Supplemental Disclosure Form
42
Non-Supervisory Employee(s) of a Junket Enterprise - Registration Form
43
(And 5
And 63)
Credit Card Authorization
44
Request for Removal from Prohibited Vendor List For Failure to Timely File Supplemental Disclosure Form
CASINO HOTEL ALCOHOLIC
BEVERAGE LICENSE
Form #
Document Name
50
Instructions For Obtaining an Initial Casino Hotel Alcoholic Beverage License or Filing For Resubmission
51
Casino Hotel Alcoholic Beverage - License Application
52
Casino Hotel Alcoholic Beverage - License Resubmission
53
Casino Hotel Alcoholic Beverage Licensee - Business Entity Disclosure Form
54
Casino Hotel Alcoholic Beverage Licensee - Business Entity Disclosure Form - Holding Company
55
Casino Hotel Alcoholic Beverage Licensee - Qualifier Disclosure Form
56
(And 36)
Equal Opportunity and Affirmative Action Obligations - Casino Service Industry Applicants/Licensees
57
Casino Hotel Alcoholic Beverage - Social Affair Permit Application
58
Casino Hotel Alcoholic Beverage - Consumer Alcoholic Beverage Tasting Permit Application
59
Casino Hotel Alcoholic Beverage - Special Disposal Permit Application
60
Casino Hotel Alcoholic Beverage - Temporary Miscellaneous Contingency Permit Application
61
Casino Hotel Alcoholic Beverage - Donation Permit Application
62
Casino Hotel Alcoholic Beverage - Merchandising Permit Application
63
(And 5 And 43)
Credit Card Authorization
64
Casino Hotel Alcoholic Beverage Licensee - Submission By a Casino Licensee For a Temporary Type III Authorization
SELF-EXCLUSION
Form #
Document Name
70
Request for Voluntary Self-Exclusion from Casino Gambling Form
71
Request for Removal from Voluntary Self-Exclusion List
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