Win/Loss Statement

Fill out the form below to receive your Win/Loss Statement (and/or) W2Gs. Please allow 2-3 weeks for processing.

Request a Win/Loss Statement (and/or) W2Gs

"*" indicates required fields

Phone

This field is for validation purposes and should be left unchanged.

Today's Date*

Name*

First Middle Last

Providing your middle name will help us differentiate you from those with a similar name.

Email*

Phone*

Player’s Card Number or Date of Birth (MM/DD/YY)*

Providing your player's card number or date of birth will help us ensure we are looking up the correct person.

Your Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If the address you provide is different than the one we have on file, you must go to the Player's Club with your personal ID in order for us to change the address on your account.

Win/Loss Only or Win/Loss + W2Gs

Win/Loss Only

Win/Loss + W2Gs

W2Gs Only

How Would You Like To Receive Your Statement(s)?*

Mailed To You

Picked Up at the Player's Club

Via Email

MAILED TO YOU: Your statement will be mailed to the address we have on file. To change your address you must come in person to the Player's Club with your ID to change it.

PICKED UP: Your statement can only be picked up by you.

VIA EMAIL: Your statement will be emailed to you.

What Year or Years Do You Want Your Statement(s) for?*

If you have any issues with this form please email comments@clearwatercasino.com

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