Update: These forms now contain fields you can fill in electronically. To do so please:

  • Download the form by clicking on the link
  • Save to your computer
  • Enter in the data into the fields.

Please note: Users have reported issues printing PDF documents while using Google Chrome and Edge. If you experience any issues with printing while using Google Chrome and Edge, please try saving the PDF document(s) and opening it locally with Adobe Acrobat Reader. Then, you can fill out and print the document(s) as needed.

The following applications and/or documents are required by the Bureau in addition to the Commission's application.

Please navigate to the California Gambling Control Commission’s webpage below to access the most current Self-Exclusion Request and Self-Exclusion Removal Request forms.

Responsible Gambling Forms