Self-Exclusion Removal Request
Pursuant to Iowa Acts - 87, Chapter 132, a person may revoke a self-exclusion only if the person self-excluded prior to July 1, 2017. Individuals who submit a request that do not meet this standard are not eligible for revocation.
It may take up to ten business days from the date of receipt for the IRGC to process a request. To request to revoke a self-exclusion, please use the following instructions:
- Open the Voluntary Self-Exclusion Revocation form on the Seamless Docs platform. Please note, this link will take you to another website.
- Complete all required fields in sections 2 and 3.
- For online submission:
- Click "Submit & Sign" in the bottom, right-hand corner.
- Complete the “Create Your Signature Page” and click "Apply Signature."
- Click “Finalize & Submit” in the bottom, right-hand corner.
- For Mail-in Submission:
- Click the print icon in the top, left-hand corner of the screen.
- Follow the print options from the device that is being used to print.
- Sign the form.
- Mail the form to:
Iowa Racing & Gaming Commission
1300 Des Moines St., Suite 100
Des Moines, IA 50309-5508
Note: This revocation request only applies to a statewide voluntary self-exclusion pursuant to Iowa Code 99D.7(23) and 99F.4(22). It doesn't apply to voluntary or involuntary exclusions, bans, or trespass orders at individual licensed entities. Please contact the licensed entity directly to discuss their removal.