Belle gaming form 2026

The document is a request form for obtaining a statement of gaming activity, specifically a Win-Loss Statement, from Marnell-Sher Gaming, Inc. It requires personal information such as the individual's name, date of birth, ACCESS Club number, and mailing address. The requester certifies the accuracy of the information provided and authorizes the company to release their gaming activity statement while agreeing to indemnify the company against any liabilities related to this request.

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Click ‘Get Form’ to open the belle gaming form in the editor.
Begin by entering your First Name and Last Name in the designated fields. Ensure that the names match your identification documents for accuracy.
Fill in your Date of Birth and ACCESS Club Number. This information is crucial for verifying your identity and accessing your gaming activity records.
Provide your Email Address, ensuring it is valid as this may be used for communication regarding your request.
Indicate if this is a change of address by circling 'YES' or 'NO'. If applicable, enter your new Mailing Address, City, State, and Zip Code.
Enter your Phone Number for any follow-up inquiries related to your request.
Specify the year(s) for which you are requesting a statement of gaming activity.
Read the certification statement carefully, then provide your signature and date at the bottom of the form. This confirms that all provided information is accurate.
If you wish to receive the statement via fax, include your Fax Number in the appropriate field.

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