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Get Presque Downs Profit Loss

Year s Requested FOR OFFICIAL USE ONLY Date Sent // Sent By WIN / LOSS STATEMENT REQUEST FORM To request a Win/Loss Statement please fill out the following information entirely and return to Players Club or mail/fax to Presque Isle Downs Casino ATTN Win/Loss FAX 814-860-3390 PO Box 10728 Erie PA 16514 Requests for Win/Loss Statements will be processed in the order in which they are received. Please allow up to 2 weeks for process and delivery. All Win/Loss Statements will be mailed to the address recorded on file. Please ensure your address and other information on your account is correct before sending in your request. The information on this form is required for identification and security purposes. Incomplete forms may cause delay. All fields are required* All Information Is Required For Faster Service. Partial SS Is Permitted* Today s Date - Requests For Current Tax Year Will Not Be Processed Til Years End - Player s Club Number First Name Last Name Mailing Address Date of Birth Social Security Number Partial Social Security Is Permitted If On File Drivers License / ID Please Include State/Providence Issued Phone Number E-Mail Address Optional* For Communication Purposes Only. Signature If you have any further questions or need help email jwagner pidowns. com or call 814 866-8773. All Win/Loss Statements will be mailed to the address recorded on file. Please ensure your address and other information on your account is correct before sending in your request. The information on this form is required for identification and security purposes. Incomplete forms may cause delay. The information on this form is required for identification and security purposes. Incomplete forms may cause delay. All fields are required* All Information Is Required For Faster Service. Partial SS Is Permitted* Today s Date - Requests For Current Tax Year Will Not Be Processed Til Years End - Player s Club Number First Name Last Name Mailing Address Date of Birth Social Security Number Partial Social Security Is Permitted If On File Drivers License / ID Please Include State/Providence Issued Phone Number E-Mail Address Optional* For Communication Purposes Only. All fields are required* All Information Is Required For Faster Service. Partial SS Is Permitted* Today s Date - Requests For Current Tax Year Will Not Be Processed Til Years End - Player s Club Number First Name Last Name Mailing Address Date of Birth Social Security Number Partial Social Security Is Permitted If On File Drivers License / ID Please Include State/Providence Issued Phone Number E-Mail Address Optional* For Communication Purposes Only. Signature If you have any further questions or need help email jwagner pidowns. com or call 814 866-8773. All Win/Loss Statements will be mailed to the address recorded on file. Please ensure your address and other information on your account is correct before sending in your request. The information on this form is required for identification and security purposes. Incomplete forms may cause delay. All fields are required* All Information Is Required For Faster Service. Partial SS Is Permitted* Today s Date - Requests For Current Tax Year Will Not Be Processed Til Years End - Player s Club Number First Name Last Name Mailing Address Date of Birth Social Security Number Partial Social Security Is Permitted If On File Drivers License / ID Please Include State/Providence Issued Phone Number E-Mail Address Optional* For Communication Purposes Only.

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