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Get Indiana Voluntary Exclusion Program Form

Indiana Voluntary Exclusion Program VEP Request for Removal State Form 52323 R / 2-11 Instructions Read Carefully Read each section of this form and the attached removal guidelines carefully before completing. Print legibly in blue or black ink. Present a valid driver s license or government-issued identification card for verification of personal information. Important Notice Under 68 IAC 6-3-5 A person may upon the expiration of the selected t.

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