Win/Loss Statement Request

It’s Very Easy!

Obtain your Win/Loss or Taxable Winnings Report in three easy ways:

1. Visit the Valley Sky Club

Simply visit the Valley Sky Club, present your government issued valid photo ID and ask for a Win/Loss Statement.

2. Mail it in

Download the form below, fill it out and mail it in.

DOWNLOAD FORM

3. Fill out the form below

Fill out and submit the form below.

Please enable JavaScript in your browser to complete this form.

Player Club #

First Name

Middle Initial

Last Name

Street Address

Apt/Ste.#

City

State

City NAME Phone

Zip

Phone Number

Alt. Phone Number

Email Address

Fax Number

Date of Birth

Tax Years Requested

Forms Requested

Taxable Winnings Report
Win/Loss Statement

Preferred Method to Receive Form(s)

Mail to address listed above
Pick-up at Valley Sky Club
Email to address listed above
Fax to number listed above

LEGAL AGREEMENT

I AGREE

The undersigned hereby authorizes Table Mountain Casino Resort to release a written summary of the undersigned’s Net W2G copies for the above said tax year(s). The undersigned hereby releases Table Mountain Casino Resort from any liability whatsoever as a result of its release of the requested information. The undersigned further acknowledges and understands that errors, omissions and other inaccuracies may exist in the released information as a result of unexpected failures or other shortcomings of the tracking system. The undersigned agrees and warrants that he/she will not release this information to any third party for any reason whatsoever without expressed written consent of Table Mountain Casino Resort, except that the undersigned may provide a copy of the released information to his/her tax preparer or attorney in connection with any tax professional services to be provided by such professional.

TYPE FULL NAME TO AGREE

TODAY'S DATE

Additional Comments

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may affect your browsing experience.

Necessary

Always Enabled

Necessary cookies are absolutely essential for the website to function properly. These cookies ensure basic functionalities and security features of the website, anonymously.

Cookie	Duration	Description
cookielawinfo-checkbox-analytics	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional	11 months	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.

Functional

Performance

Analytics

Others