Terms you can choose
Five years or lifetime, chosen at signing; 'once made, the election by the Player is irrevocable and cannot be rescinded.' No limit on repeated five-year terms. Removal is available only to those who signed on or before 2017-06-30, and only after being listed at least five years; the removal form is a perjury-penalty certification, not a notarized document.
Sign up for the longest exclusion time you can. Future you will thank you.
When it ends
This has no published way to lift it.
How removal works. Once made, the choice of term is irrevocable and cannot be rescinded. A removal request is available only to people who signed on or before June 30, 2017, after being listed at least five years; no removal route is published for anyone signing after that date, whichever term they choose.
On a lifetime term. Lifetime is one of the two terms offered; the same irrevocability and removal limits apply. No removal route is published for a lifetime choice made after June 30, 2017.
How to enroll
Take the signed, notarized contract to any Iowa Lottery regional office.
The completed, notarized contract is turned in in person; no mailing address is published for enrollment. Regional offices have notaries on site. No confirmation or receipt process is published, so turning in the form does not by itself confirm you're enrolled.
- Get the four-page self-exclusion contract from the Iowa Lottery site, or from any regional office. We don't fill in or submit this form.
- Fill in every field -- your driver license number and state, date of birth, full Social Security number -- and attach a recent photo. Choose your term: five years or lifetime.
- Sign in front of a notary. Regional offices have notaries on site; whether a remote online notary is accepted for this contract is not established.
- Turn in the completed, notarized contract in person at any Iowa Lottery regional office. No mailing address is published for enrollment.
- Once made, your choice of term is irrevocable and cannot be rescinded. A removal request exists only for people who signed on or before June 30, 2017, and only after being listed five years -- if you sign today, no removal route is currently published for you, whichever term you pick.
Official form (Filename token indicates 2017-06-22; no printed revision date on the contract itself) Program page
Before you count on it. This only covers the Iowa Lottery's own five regional offices -- it's separate from the Iowa Racing and Gaming Commission's casino, racetrack, sports-wagering and fantasy-sports program, and the Lottery's own page says signing this contract does not enroll you in that one; you have to sign both to be excluded from both. Enforcement at retail lottery ticket sellers is stated to be not feasible, so this does not stop you from buying tickets at a store. Whatever term you choose is irrevocable, and the published removal form only applies to people who signed on or before June 30, 2017 and have been listed five years -- if you're signing today, there is currently no published way off this list. Whether a remote online notary is accepted for this contract is not established; RON is confirmed only for the separate IRGC program. Turning in the form does not by itself confirm you're enrolled; no confirmation or receipt process is published.
Every route we checked
Routes that enroll you
- In person — Any Iowa Lottery regional office
The completed, notarized form is turned in at any regional office.
Routes that get you a form or an answer, not an exclusion
- By phone — (515) 725-7900, Lottery VP of External Relations
Published only for reporting continued receipt of promotional materials after enrollment, not for submitting a request. A removal request (available only to pre-2017-07-01 enrollees after 5 years listed) is instead returned in person to any regional office or mailed to Iowa Lottery, 13001 University Ave., Clive, Iowa 50325 -- a withdrawal-only address, not recorded as a channel here.
Requirements and sources
Sources read 2026-09-24. These are the program's requirements, not a record of anyone's enrollment.
- Terms available
- Five years or lifetime, chosen at signing; 'once made, the election by the Player is irrevocable and cannot be rescinded.' No limit on repeated five-year terms. Removal is available only to those who signed on or before 2017-06-30, and only after being listed at least five years; the removal form is a perjury-penalty certification, not a notarized document.
- Can a resident enroll
- Not verified: Neither the contract nor the removal form states a residency requirement.
- Can a visitor enroll
- Not verified: Neither the contract nor the removal form states a residency requirement.
- Identification
- Driver license number and state, date of birth and full Social Security number are requested on the contract, plus a photo.
- Notarization
- Required for enrollment; the Lottery's own regional offices have notaries available on site.
- Witnesses
- Not verified: No witness requirement beyond the notary is stated.
- Notarizing online
- Not verified: The contract requires notarization but no source addresses whether a remote online notary is accepted for the Lottery's own program (RON is confirmed only for the separate IRGC program).
- How long processing takes
- Not verified: No processing-time interval is published.
- How you are told it took effect
- Not verified: No confirmation or receipt mechanism is described.
The form asks for: driver license number and state, date of birth, full Social Security number, a recent photo, chosen term: 5 years or lifetime, notarized signature.
- Iowa Lottery Authority Self-Exclusion from Play and Prize Payment Agreement ialottery.com · read 2026-09-24
- Legal - Voluntary Self-Exclusion Program ialottery.com · read 2026-09-24
- Request for Removal from Iowa Lottery Voluntary Self-Exclusion List ialottery.com · read 2026-09-24