Self exclusion form 2026

1. Click ‘Get Form’ to open the self-exclusion form in the editor.
2. Begin by filling in your full name and date of birth clearly at the top of the form. This information is essential for identification purposes.
3. Next, provide any aliases or nicknames you may have, along with your race and physical address. Ensure that all details are accurate to avoid any issues.
4. In the personal description section, fill in your height, weight, hair color, eye color, sex, and any distinguishing scars or tattoos. This helps in verifying your identity.
5. Indicate your acknowledgment of being a problem gambler by signing where indicated. Choose the duration for which you wish to be excluded: One Year, Five Years, Ten Years, or Permanent.
6. Review the terms and restrictions carefully before signing again at the bottom of the form. This ensures you understand your responsibilities during the exclusion period.
7. Finally, attach a copy of your driver’s license as required and submit the completed form to the Choctaw Nation Gaming Commission via mail or delivery.

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