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Appeal an Exclusion

Exclusion Appeal

Appeal an Exclusion Decision

Use this form to appeal an exclusion decision made by a gambling facility. The Gambling Authority will review your application and contact you if more information is needed.

Have you ever received an Exclusion reference number? *

Yes No

Exclusion Reference No

Full Name *

Player's Omang/Passport No *

Email Address *

Contact No

Gambling Facility *

Reason for application *

By activating this checkbox, I confirm that the information provided is correct.

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