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PDFWAC 230-23-010

Request for self-exclusion.

(1) Any person may request to be placed on the self-exclusion list voluntarily excluding themselves from house-banked card room licensees:
(a) In person at our office, 4565 7th Avenue S.E., Lacey, Washington 98503, or at a house-banked card room licensee by:
(i) Submitting a completed form, which we provide on our website at www.wsgc.wa.gov; and
(ii) Providing proof of identity. Acceptable forms of identification include:
(A) A valid driver's license from any state;
(B) A government-issued identification card containing the person's name, photograph, and date of birth; or
(C) A valid passport; and
(iii) Submitting a photograph showing only the head and shoulders; or
(b) Through the mail to Washington State Gambling Commission, P.O. Box 42400, Olympia, Washington 98504 by:
(i) Submitting a completed form, which we provide on our website at www.wsgc.wa.gov; and
(ii) Submitting a photograph showing only the head and shoulders.
(2) The form must be:
(a) Completed with no areas left blank; and
(b) Signed under penalty of perjury by the person seeking self-exclusion.
(3) Upon receipt of a completed form, the licensee will forward it to us within 72 hours.
(4) The commission must begin exploring an online self-exclusion enrollment process within six months of modernizing legacy information technology systems.
[Statutory Authority: RCW 9.46.070 and 9.46.071. WSR 22-05-019, ยง 230-23-010, filed 2/4/22, effective 5/1/22.]
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