Terms you can choose
Choose one, five or ten years, irrevocable during the selected period. The FAQ says the name is removed when that duration ends; renewal requires a new notarized application and current color photo. No expiration notice is sent. Separate corporate restrictions may differ.
When it ends
This ends on its own at the end of the term.
The FAQ states the name is removed when the chosen duration ends; the term is irrevocable until then and no expiration notice is sent. Staying excluded past that point takes a new notarized application and a current color photo.
How to enroll
Open the official form.
This opens Arizona's own form. You still complete it, have it notarized and deliver it. Arizona does not notify you when the exclusion takes effect, so call 602-771-4263 afterwards to confirm.
- Complete the official form and initial your coverage choice, term and acknowledgments. We don't fill in or submit this form.
- Sign with a notary and include a current color head-and-shoulders photo, at least 2 × 3 inches. An ID copy cannot replace the photo. The Department accepts an online notarization but does not offer one; its own notary is in Phoenix only.
- Mail or deliver the original to the department within 90 days of notarization. The form lists the address (100 N 15th Ave. Suite 202, Phoenix, AZ 85007) and allows emailing the photo. You can also email a scanned PDF of the whole application to selfexclusion@azgaming.gov or publicaffairs@azgaming.gov; the Department says its Constituent Services Unit watches both inboxes for applications, so either one works.
- Call 602-771-4263 to confirm your exclusion is active; Arizona does not send an activation notice.
Official form (04092025) Program page
Before you count on it. You do not have to live in Arizona to apply. Opening or sending the form does not confirm enrollment.
Every route we checked
Routes that enroll you
- By mail — Arizona Department of Gaming, 100 N 15th Ave. Suite 202, Phoenix, AZ 85007
Mail or deliver the original notarized application and required photo to the department. The Department's 2026-10-05 reply asks mailers to use this address. - In person — Arizona Department of Gaming, 100 N 15th Ave. Suite 202, Phoenix, AZ 85007
Mail or deliver the original application to the published address. For an EWFS in-person signing appointment, call 602-771-4263 so a notary is available; the office offers photo/notary help. The Department wrote on 2026-10-05 that it offers self-exclusion notary services only at its Phoenix office. - By email — selfexclusion@azgaming.gov or publicaffairs@azgaming.gov
Email the completed application as a scanned PDF to either address. The Department named both on 2026-10-06: "Applicants can submit via email using either our self-exclusion email inbox (not currently on the website) or our public affairs email inbox", and "The Department's Constituent Services Unit monitors both inboxes for self-exclusion photo/application form submissions, so either inbox works for us." It had already written on 2026-10-05 that "Yes, self-exclusion application forms can indeed be submitted via email, as long as the application is scanned and submitted as a PDF file", and problemgambling.az.gov/self-exclusion now agrees: "Photos and application forms may also be submitted electronically, and must be submitted via a PDF scanned copy." Neither Department page names an inbox, so the written answers are what establish this route. The application still has to be notarized, and emailing it brings no receipt.
Routes that get you a form or an answer, not an exclusion
- By phone — 602-771-4263
Published contact for questions. Calling does not enroll you. - By email — publicaffairs@azgaming.gov
Published contact for questions, and the address the form gives for the required photograph. It also takes a completed application — see the email enrollment route. - By email — selfexclusion@azgaming.gov
The self-exclusion FAQ publishes this mailbox for complaints related to self-exclusion (Constituent Services Unit). No Department page lists it as an application address; the Department wrote on 2026-10-06 that it is one anyway — see the email enrollment route.
Requirements and sources
Sources read 2026-10-06. These are the program's requirements, not a record of anyone's enrollment.
- Terms available
- Choose one, five or ten years, irrevocable during the selected period. The FAQ says the name is removed when that duration ends; renewal requires a new notarized application and current color photo. No expiration notice is sent. Separate corporate restrictions may differ.
- Can a resident enroll
- You do not have to live in Arizona. The Department wrote to us on 2026-10-05 (its public affairs office; the reply is signed only "Arizona Department of Gaming"): "Yes, out of state residents/visitors can apply and be included on Arizona's self-exclusion list(s)." No published source says this either way: the Department's pages speak of "Arizonans", neither application asks for residency, and A.R.S. 5-1320, R19-4-150 and the Self-Exclusion Procedure (rev. 10/01/2025) are silent. The written answer is what establishes it. It speaks of out-of-state residents and visitors in general and does not name Utah.
- Can a visitor enroll
- A visitor to Arizona can apply. The Department wrote to us on 2026-10-05 (its public affairs office; the reply is signed only "Arizona Department of Gaming"): "Yes, out of state residents/visitors can apply and be included on Arizona's self-exclusion list(s)." The pages, statute, rule and Procedure remain silent on residency; the written answer is what establishes it.
- Identification
- Application requires identity and physical-description fields, SSN and driver license details, plus a current color head-and-shoulders photo at least 2 by 3 inches. Photo-ID/passport/license copies cannot replace the photograph. Contact the department before applying if required identity information is unavailable.
- Notarization
- The form must be properly notarized and received within 90 days of notarization. Mail or deliver the original, or email a scanned PDF to selfexclusion@azgaming.gov or publicaffairs@azgaming.gov. Emailing it does not skip the seal: get your own notary, online or in person, for either route. Call for an appointment if signing at the department so a notary is available. The Department wrote on 2026-10-05 that it accepts online notarizations but does not offer remote notarization itself; its own self-exclusion notary service is at its Phoenix office only, and it named both inboxes on 2026-10-06.
- Witnesses
- Not verified: The application has a notary certification; it does not establish a separate witness requirement or an exception to notarization.
- Notarizing online
- Remote online notarization is accepted, but the Department does not provide one. It wrote to us on 2026-10-05 (its public affairs office; the reply is signed only "Arizona Department of Gaming"): "Yes, we accept both online notarizations and applications submitted electronically (including digital signatures). However, the Department does not offer remote/online notarizations. We only offer self-exclusion notary services at our office in Phoenix." No published source says this: the Self-Exclusion Procedure reads "Signature and Date (must be signed IN FRONT of the Notary Public)" and the form's jurat reads "Subscribed and sworn to (or affirmed) before me". The answer does not name an online notary provider or say whose notary commission it accepts, so a Utah-commissioned remote notary is not established. The forms still call for notarization.
- How long processing takes
- The FAQ says a properly completed application and photograph are usually processed the same day they reach the department. This is a usual interval, not a guaranteed deadline or proof of activation.
- How you are told it took effect
- The department sends no receipt, activation or expiration notification. The FAQ directs applicants to call the office at 602-771-4263 to confirm. Sending the form does not mean you are enrolled.
The form asks for: legal name, street address, city, state and ZIP, home or cell phone, driver license number and state, date of birth, age, race, aliases (N/A if none), Social Security number, height, weight, eye color, hair color, sex, coverage option initials, term initials, acknowledgment initials, applicant name, signature and date, notary certification, current color head-and-shoulders photo at least 2 by 3 inches.
- Arizona Department of Gaming self-exclusion gaming.az.gov · read 2026-09-16
- Arizona Department of Gaming, written answer to BanMyself naming the two mailboxes that accept an emailed self-exclusion application written answer received 2026-10-06
- Arizona Department of Gaming, written answers to BanMyself on submitting an application by email, remote notarization and out-of-state applicants written answer received 2026-10-05
- Arizona Division of Problem Gambling exclusion instructions problemgambling.az.gov · read 2026-09-16
- Arizona EWFS self-exclusion application, revision 04092025 problemgambling.az.gov · read 2026-09-16
- Arizona self-exclusion FAQ problemgambling.az.gov · read 2026-09-16