Self-Exclusion Removal Request

Pursuant to Iowa Code 99D and 99F, as amended in 2017 by SF 442 enacted on July 1, 2017, the Iowa Racing & Gaming Commission will accept a hard copy of the attached form or a submission of the below online form.  

A person may revoke the voluntary exclusion only if the person elected to be voluntarily excluded prior to July 1, 2017 AND the person has been voluntarily excluded for a period of at least five years as of the date of this application.  Individuals who submit a form prior to the expiration of the five year exclusion will not be eligible for revocation and a new form must be submitted at a later date

NOTE:  This revocation only applies to a statewide self-exclusion pursuant to Iowa Code sections 99D.7(23) and 99F.4(22) and does NOT apply to voluntary or involuntary bans or trespass orders at individual casinos or racetracks.

Enter only the last 4 digits of your social security number.
XXX-XX-
Please indicate the approximate date you signed the lifetime self-exclusion at a casino. Please note, lifetime self-exclusions signed after July 1, 2017 are not eligible to be revoked.

Printed from the Iowa Racing and Gaming Commission website on November 20, 2017 at 10:09pm.