(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.