Bingo Online Complaint Form

The information you report will help us investigate complaints and possible violations of the Bingo Enabling Act, Administrative Rules of the Commission and/or Title II of the Americans with Disabilities Act.

To submit a complaint:

Fill in the information below, or
Download the complaint form (PDF version) to send in via postal mail/fax.
All complaints must allege a possible violation of the Bingo Enabling Act, Administrative Rules of the Commission and/or Title II of the Americans with Disabilities Act.
An asterisk (*) indicates required information.
If required fields are not filled in the complaint form can not be submitted.
Please read our Privacy Statement and a notice about filling in this form.
Note: Information may be subject to release under the Texas Public Information Act.

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Complaint Form

Please complete all fields then submit your complaint

A. Your name and contact information:

* First Name Please enter your first name.

Middle Initial

* Last Name Please enter your last name.

* Address Please enter your address.

* City Please enter your city.

* State Please enter your state.

* Zip Please enter your zip code, numbers only.

* Daytime Phone Please enter your daytime phone, numbers only.

Alternate Phone

Email Address

B. Complaint information:

* Date of Incident Please enter date of incident in format mm/dd/yyyy.

* Time of Incident Please enter time of incident.

* AM or PM

AM PM Please select AM or PM.

* Name of Bingo Hall/Organization Please enter name of bingo hall or organization.

Bingo Hall Address

* City Please enter location city.

StateTX

Zip

* Details of Complaint - provide specific details regarding the incident Please enter details of complaint.

C. Additional information (if known):

Name of Bingo Worker

Bingo Worker Registry # / License #

Names of individuals involved and/or witnesses

D. ADA (Americans with Disabilities Act) Complaint:

If your ADA complaint is against a program, service, or activity of the Texas Lottery Commission, briefly describe it in the space above. Remember to include names of individuals and/or witnesses involved. If your ADA complaint is against a lottery retailer, please also complete Lottery Retailer information portions of the Lottery Complaint Information above.

By checking this box, you are certifying that you are a disabled person as described in the American with Disabilities Act and to the best of your knowledge and belief, the statements made in this complaint are true and accurate.

Are you human?:

The person filing the complaint must include his/her name, mailing address and contact phone number.
All complaints must allege a possible violation of the Bingo Enabling Act, Administrative Rules of the Commission and/or Title II of the Americans with Disabilities Act.

Note: Information may be subject to release under the Texas Public Information Act.

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