Win Loss Request | Spotlight 29 Casino

location

property

first name

last name

E-Mail

date of birth

(mm/dd/yyyy)

last 4 social

club number

Type of Form(s) Requested

Type of Form(s) Requested:

Win / Loss
1099 Form
W2G Form

Years Requested

Year(s) Requested:

2016
2017
2018

Preferred Method of Delivery

Preferred Method of Delivery

Postal Mail: Requested Form will be sent my U.S. Postal Mail, The requested forms will be mailed to the address on file. (Please allow up to two weeks for delivery)

Pick up in person: Pick up the requested forms in person at the Casino Host Office for Spotlight 29 Casino or at Club 29 at Tortoise Rock Casino. ID will be required for pick up. (Please allow up 10 Days for processing)

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I hereby declare that the above furnished details are true to the best of my knowledge under penalty of perjury.

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