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Get Indiana Voluntary Exclusion Program Form
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How to fill out the Indiana Voluntary Exclusion Program Form online
This guide provides clear and detailed instructions on how to fill out the Indiana Voluntary Exclusion Program Form online. Whether you are a first-time user or need assistance, this guide will help you navigate the form with ease.
Follow the steps to successfully complete your form submission.
- Click ‘Get Form’ button to obtain the Indiana Voluntary Exclusion Program Form and open it in your online editor.
- Begin by providing your full legal name in the section labeled 'Personal Information.' Ensure that you write legibly and use blue or black ink if you print it out.
- In the same section, list any aliases or nicknames you may have used previously.
- Next, complete your residential address, including your street or P.O. Box, city, state, and zip code.
- Provide your residential telephone number and any other telephone numbers you may have.
- Indicate your date of birth and the date you enrolled in the Voluntary Exclusion Program.
- In the Certification of Witness section, ensure that an Indiana Gaming Commission (IGC) employee or designated agent witnesses your signature.
- Sign where indicated to certify that the information provided is accurate and to request removal from the VEP.
- If applicable, complete the Interpreter Information section if you required assistance. This includes providing the interpreter’s details and their affirmation.
- Review all filled sections to ensure accuracy, then save your changes, download, print, or share the form as needed.
Complete your Indiana Voluntary Exclusion Program Form online today to ensure your request is processed efficiently.
Related links form
To remove a self-ban, you must complete the Indiana Voluntary Exclusion Program Form again, requesting to lift your self-exclusion. After submitting your request, you may have to wait for a designated period, depending on the original length of your self-exclusion. The Indiana Gaming Commission will review your request and inform you of the outcome.
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