Terms you can choose
Lifetime. Removal is not automatic and may only be requested no earlier than five years after placement, and is not effective until the Board processes it and notifies the person in writing.
Lifetime is the only term this program offers.
When it ends
This continues until a removal is granted.
How removal works. Placement is for life. A removal request may not be made earlier than five years after placement, and removal is not effective until the Board processes it and notifies the person in writing.
On a lifetime term. Lifetime is the only term, so the same removal rule applies: a request no earlier than five years after placement, effective only once the Board processes it.
How to enroll
Call 888-223-3044 to book your appointment.
You join this list only at an in-person appointment at the Board's Detroit or Lansing office. The phone line, or the Board's online request form, books that appointment. An online request is not a confirmed appointment; a representative calls you back. Booking is not enrollment. Your name is added when the appointment is complete. Someone who holds your power of attorney, or a court document giving them that authority, can request placement for you. They complete the Board’s Legal Representative Attestation Form (MGCB-AD-2507), and it goes in with your application and that legal document. The Board says submitting it doesn’t guarantee approval.
- Download the eleven-page packet and complete every field and the fourteen sworn questions. Initial every page. Leave the last page unsigned; you sign it in front of the Board's notary at your appointment. We don't fill in or submit this form.
- Book an appointment at Cadillac Place, 3062 West Grand Blvd, Suite L-700, Detroit, or the Lottery Building, 101 E. Hillsdale Street, Lansing. Call 888-223-3044 or 313-456-4100, or send the Board's online appointment request and wait for the call back.
- Bring the packet and a current driver license or other government photo ID. The Board takes your photo, notarizes the form and adds your name when the appointment is complete. If you need an interpreter, the Board uses a free phone translation service; a friend or relative can’t translate for you, and those appointments typically take an hour.
- Leave with your copy of the application, the Confidential Notice of Placement and the Confidential Order of Placement. Keep them. If your name, address or phone number changes later, fill in the Board’s Information Update Notification (MGCB-AD-1015) with the file number from those papers. Mail it or hand it in, in an envelope marked CONFIDENTIAL, to the Responsible Gaming Section, Michigan Gaming Control Board, Cadillac Place, 3062 W. Grand Blvd., Suite L-700, Detroit, MI 48202-6062.
Official form (MGCB-AD-1050 Rev. 04/25) Program page 888-223-3044
Before you count on it. There is no mail, email or online way onto this list, and the form carries no submission address. MGCB-DPL@michigan.gov is the Board's removal mailbox; sending your application there enrolls you in nothing. Placement is for life. You can ask for removal no earlier than five years after placement, and it takes effect only when the Board notifies you in writing. The pages we read don’t say whether you have to live in Michigan or whether there’s a fee. Booking the appointment doesn’t put you on the list by itself.
Every route we checked
Routes that enroll you
- In person — Michigan Gaming Control Board, Cadillac Place, 3062 West Grand Blvd., Suite L-700, Detroit, MI 48202
By appointment only. The application must be completed in person; the form itself publishes no submission address of any kind. Checked again on 2026-09-17. - In person — Michigan Gaming Control Board, Lottery Building, 101 E. Hillsdale Street, Lansing, MI 48933
By appointment only; the applicant chooses which office.
Routes that get you a form or an answer, not an exclusion
- By phone — 888-223-3044 or 313-456-4100
Books the required appointment. Booking is not enrollment. If you don’t remember whether you joined, the same line books an appointment to check. - Online — https://www.michigan.gov/mgcb/resources/responsible-gaming/contact-us
Official appointment-request web form with a DPL Appointment Request topic, verified 2026-09-17. It explicitly states that an appointment or event request is not confirmation of an appointment and that a representative will call to confirm availability. This is an inquiry route; enrollment happens at the appointment.
Requirements and sources
Sources read 2026-09-17. These are the program's requirements, not a record of anyone's enrollment.
- Terms available
- Lifetime. Removal is not automatic and may only be requested no earlier than five years after placement, and is not effective until the Board processes it and notifies the person in writing.
- Can a resident enroll
- Not verified: No source addresses out-of-state applicants. One explicit exclusion exists: a person holding a Detroit casino occupational license may not join, because they would not be permitted on the gaming floor. No reviewed source addresses residency eligibility.
- Can a visitor enroll
- Not verified: No source addresses out-of-state applicants. One explicit exclusion exists: a person holding a Detroit casino occupational license may not join, because they would not be permitted on the gaming floor. No reviewed source addresses residency eligibility.
- Identification
- The applicant must appear in person and bring a current driver license or government-issued photo identification. The photograph is taken at the appointment.
- Notarization
- Required, and performed at the Board office during the appointment: the applicant is told not to sign the last page until then.
- Witnesses
- Not verified: No witness requirement is stated.
- Notarizing online
- Not verified: Notarization is performed in person at the Board office during the appointment, so remote online notarization does not arise.
- How long processing takes
- Placement takes effect on completion of the appointment; the name is added only after the appointment is completed.
- How you are told it took effect
- The applicant receives a copy of the completed application, a Confidential Notice of Placement and a Confidential Order of Placement.
The form asks for: name, current residence address, mailing address if different, Social Security number, primary and alternative telephone, date of birth, driver license number and state, email, sex, height, weight, hair color, eye color, skin color or race, casino players card account information, other names or aliases, occupation, business telephone and address, two vehicle descriptions with plates, other physical characteristics, fourteen sworn questions, signature with notary block, supporting affidavit and release, addenda initialled, initials on every page, photograph taken at the appointment.
- MCL 432.225, Michigan disassociated persons list legislature.mi.gov · read 2026-09-17
- MGCB responsible gaming FAQ michigan.gov · read 2026-10-24
- MGCB Self-Exclusion Forms michigan.gov · read 2026-10-24
- MGCB tribal casinos michigan.gov · read 2026-09-17
- Michigan Gaming Control Board responsible gaming michigan.gov · read 2026-09-17
- Michigan MGCB-AD-1015 Disassociated Persons List Information Update Notification, 09/21 michigan.gov · read 2026-10-24
- Michigan MGCB-AD-1050 Disassociated Persons List application, Rev. 04/25 michigan.gov · read 2026-09-17
- Michigan MGCB-AD-2060 Disassociated Persons List removal application michigan.gov · read 2026-09-17
- Michigan MGCB-AD-2507 Legal Representative Attestation Form, Rev. 5/2026 michigan.gov · read 2026-10-24