Terms you can choose
One fixed term: “this self-exclusion constitutes an irrevocable One Year ban effective five (5) days proceeding the date of this request”. Cooling-off: “The person named within this self-exclusion must request in person and in writing to self-lift the exclusion within five (5) days from the date the self-exclusion was signed. Failure to act within the five (5) day time period shall result in an irrevocable One Year ban term.” Return after the year: “If you have previously completed a self-ban form and now wish to return to casinos or gaming facilities, you may complete the Exclusion Repeal Form.” The repeal form says the exclusion “will remain in effect, and enforceable, until I have received written notification from Osage Casino personnel otherwise” and offers a hearing before the Osage Casinos' Executive Repeal Committee.
When it ends
A fixed term continues until a removal is granted; whether a permanent term exists, and what would govern it, is not established.
A fixed term. The ban is an irrevocable one year. It then stays in effect until Osage Casino gives written notice that it's lifted, after an Exclusion Repeal Request and possibly a hearing before the Executive Repeal Committee.
A lifetime term. Not verified: The form lists one term, an irrevocable one-year ban, and doesn't say whether a lifetime ban is available.
How to enroll
Fill out the Self-Ban Form at any Osage Casino.
Ask at any Osage Casino for the Self-Ban Form. Staff look at your ID and certify your signature on the spot. You can download the form first to see what it asks.
- Go to any Osage Casino and ask for the Self-Ban Form, or download it first to read it. We don't fill in or submit this form for you.
- Fill in your full name, address, date of birth, home and business phone, ID number and issuing state, and a physical description, including scars or tattoos.
- A photo goes on the form. Staff record the ID you show and certify that your signature matches it.
- The ban starts five days after you sign. Within those five days you can lift it only by asking in person and in writing. After that, it is an irrevocable one-year ban.
- Keep a copy. The form doesn't describe a receipt or a confirmation.
Official form (O.C. Security 0800705-037) Program page
Before you count on it. This covers Osage Casino properties only. It is separate from Oklahoma's statewide OAPGG list, which doesn't include the Osage Nation. The ban lasts one year and can't be lifted during it. After the year it stays in effect until Osage Casino tells you in writing that it's lifted; you ask with the Exclusion Repeal Request, and you may get a hearing. The Gaming Commission says a completed form can also be mailed, but doesn't say whether the Pawhuska or the Tulsa office receives it, so doing it in person is the sure route.
Every route we checked
Routes that enroll you
- In person — Any Osage Casino
“You may complete a self-ban form at any of our casinos”. - By mail Not verified — Osage Nation Gaming Commission (page lists a Pawhuska office, 612 Leahy Avenue, Pawhuska, OK 74056, and a Tulsa office, 1211 West 36th Street North, Tulsa, OK 74127)
The page says the completed form can be returned “to the Osage Nation Gaming Commission in-person or via U.S. Mail” but does not say which office receives mailed forms. The addresses sit under a general Contact Information heading, so they are not recorded as an intake address.
Requirements and sources
Sources read 2026-10-01. These are the program's requirements, not a record of anyone's enrollment.
- Terms available
- One fixed term: “this self-exclusion constitutes an irrevocable One Year ban effective five (5) days proceeding the date of this request”. Cooling-off: “The person named within this self-exclusion must request in person and in writing to self-lift the exclusion within five (5) days from the date the self-exclusion was signed. Failure to act within the five (5) day time period shall result in an irrevocable One Year ban term.” Return after the year: “If you have previously completed a self-ban form and now wish to return to casinos or gaming facilities, you may complete the Exclusion Repeal Form.” The repeal form says the exclusion “will remain in effect, and enforceable, until I have received written notification from Osage Casino personnel otherwise” and offers a hearing before the Osage Casinos' Executive Repeal Committee.
- Can a resident enroll
- Not verified: Neither the page nor the form states a residency requirement.
- Can a visitor enroll
- Not verified: Neither the page nor the form states a residency requirement.
- Identification
- The form asks for an identification number and state, and the staff block reads “Type of I.D. Offered ... I certify that the signature of the person requesting self-exclusion of gaming privileges appear to agree with that contained on the above identification credentials”. A photograph is attached to the form.
- Notarization
- Not verified: The form has no notary block and the page does not mention notarization; staff certify the signature against ID instead. Not stated whether a mailed form needs anything more.
- Witnesses
- Not verified: No witness requirement is stated.
- Notarizing online
- Not verified: Notarization is not mentioned, so remote notarization is not addressed.
- How long processing takes
- Not verified: The form says the ban runs from five days after the date of the request. No processing timeline is published.
- How you are told it took effect
- Not verified: No receipt or confirmation is described.
The form asks for: full name, street address, date of birth, home and business phone, identification number and state, physical description (height, weight, hair, eyes, gender, scars/tattoos, ethnicity), photograph (“Insert Photo Here”), signature and date.
- Osage Casino Exclusion Repeal Request (O.C. Security 0800819-099) osage-multimedia.s3.amazonaws.com · read 2026-10-01
- Osage Casino Self-Ban Form (O.C. Security 0800705-037) osage-multimedia.s3.amazonaws.com · read 2026-10-01
- Osage Nation Gaming Commission - Banned Patrons (self-ban and exclusion repeal forms) osagenation-nsn.gov · read 2026-10-01