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Get Golden Gaming Win/Loss Statement Request Form

Please fill out and sign below. INSERT HERE WIN/LOSS STATEMENT REQUEST FORM IM A WINNER 0123456789 Player s Card REQUIRED Property Played First Name Last Name Street Address City State Zip Phone I am requesting a copy of my Win/Loss statement from Golden Gaming. I understand that the fill in year here Win/Loss statement provided to me will only reflect my activity while signed on to the club system for the players card number listed above only. Signature Date Fax back to 702. 891. 4205 Attention Audit Email win-loss-statement ggilv*com PLEASE ALLOW 10-14 BUSINESS DAYS FOR PROCESSING. I understand that the fill in year here Win/Loss statement provided to me will only reflect my activity while signed on to the club system for the players card number listed above only. Signature Date Fax back to 702. 891. 4205 Attention Audit Email win-loss-statement ggilv*com PLEASE ALLOW 10-14 BUSINESS DAYS FOR PROCESSING. .

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