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Get NJ Internet Gaming Dispute Form 2023-2024

Ne #: E-Mail Address: Zip Code: Player/User ID: Website Address: Nature (Type) of Complaint: Date of Original Complaint to Operator: Date of Response from Operator: I certify that the above information is true and accurate to the best of my knowledge: Initials: Date: ANY SUPPORTING DOCUMENTATION TO THIS DISPUTE MUST BE ATTACHED AS PART OF THE EMAIL PRIOR TO SENDING. Please do not submit any Personally Identifiable Information (PII) via email. PII Includes: Social Securi.

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