Casino / Sportsbook Patron Dispute/Complaint Form

Questions or comments regarding patron disputes or complaints can be directed to the Pennsylvania Gaming Control Board at casinocomplaints@pa.gov.

PLEASE COMPLETE ALL INFORMATION - BE AS DETAILED AS POSSIBLE

Name of individual filing a dispute or complaint:

First

Last

Home Address:

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone

Email Address

Date and Approx Time of Incident

Complaint Type (Choose One)

Licensed Gaming Entity Where Incident Occurred:

Please provide a summary of the incident or dispute to the best of your knowledge. Include any statements which you made to the licensed gaming entity's personnel or any statements you made to witnesses to the incident or dispute.

ATTACHMENTS or DOCUMENTATION?
While NOT REQUIRED to file a complaint, if you have items (texts, screen shots, emails, etc.) relating to this complaint upload them before this form is submitted

*For security reasons, only certain file types are allowed.

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Casino / Sportsbook Patron Dispute/Complaint Form

ATTACHMENTS or DOCUMENTATION?While NOT REQUIRED to file a complaint, if you have items (texts, screen shots, emails, etc.) relating to this complaint upload them before this form is submitted

*For security reasons, only certain file types are allowed.

*For security reasons, only certain file types are allowed.

ATTACHMENTS or DOCUMENTATION?
While NOT REQUIRED to file a complaint, if you have items (texts, screen shots, emails, etc.) relating to this complaint upload them before this form is submitted