Request Form

Win/Loss Request Form

Need a record of your gaming activity for tax or personal purposes? Use our Win/Loss Request Form to obtain a detailed statement of your wins and losses from [Casino/Resort Name].

What is a Win/Loss Statement?

A Win/Loss Statement provides a summary of your gaming activity based on your player’s club account. It is typically used for:

• Tax preparation and reporting
• Personal record-keeping
• Verifying gaming history

Please note: This statement is not an official tax document and reflects tracked play only.

How to Request

1. Download the form or complete the online request below.
2. Provide the following information:
   • Full legal name
   • Player’s Club account number
   • Address
   • Phone number
   • Valid photo ID
3. Submit the request:
   • Online via this page
   • By email: records@yourcasino.com
   • By mail: [Your Casino Name], Attn: Win/Loss Dept., [Mailing Address]

Terms & Conditions

• Only the account holder may request their Win/Loss Statement.
• Valid government-issued ID is required for verification.
• Please allow up to 10 business days for processing.
• The statement will be sent to the address or email on file.

Request Form

Download Win/Loss Request Form (PDF)

Or fill out the online form here:

👉 Submit Online Request

Questions?

If you have any questions or need assistance, contact our Win/Loss Department at:

📞 [Customer Service Phone Number]
📧 records@yourcasino.com