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Send win loss request form via email, link, or fax. You can also download it, export it or print it out.
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Click ‘Get Form’ to open the win-loss request form in the editor.
Begin by entering your first name, middle initial, and last name in the designated fields. Ensure accuracy for identification purposes.
Fill in your mailing address, including city, state, and zip code. This information is crucial for correspondence regarding your request.
Provide your Social Security Number as it is required for processing the W-2G data. Also, include your phone number and email address for any follow-up communication.
Enter your date of birth in the specified format (mm/dd/yyyy) and indicate the tax year you are requesting information for.
Select one or both options for the type of statement you wish to receive: Win-Loss Statement or W-2G Data.
Read and agree to the Request Agreement by signing and dating the form at the bottom before submission.
Once completed, return the form either in person or via mail to Indian Head Casino at the provided address.
Start filling out your win-loss request today using our platform for free!
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