Win/Loss Request

Type of Form(s) Requested:

Win / Loss
1099 Form
W2G Form

Year(s) Requested:


Delivery Methods:

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)

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