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A win/loss tax form must be submitted for each property from which a Win/Loss Statement is requested.

The gaming history regarding your Player's Club Member card account is the cumulative win or loss amount form gaming activity for which your Player's Club Member card was used. A positive number indicates the amount you have won, while a negative number indicates a loss.

The information provided is recorded using the Player Performance System, which is utilized as a marketing tool, and the casino makes no representation as to the accuracy of this information. The information provided is based solely upon play using the Player's Club Member card and does not reflect wins or losses from games that do not accept the Player's Club Member card or if instances where the Player's Club Member card was not properly inserted or used.

This statement is not designed to replace a gaming diary which the IRS recommends that each player keep with important information such as dates of play, machine or table numbers, jackpot amounts and total wins or losses, Consult your tax advisor to utilize this document or a gaming diary in preparing tax returns.

A Win/Loss statement is not a substitute for W2G information, W2G may be requested on this form also, check the appropriate boxes.

Please provide a copy of Driver's License with this form.