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Get Greektown Casino Win/Loss Statement Request

Win/Loss Statement Request Printed Name Club Greektown Account Number Street Address City State Zip Home Phone Alternate Phone Social Security Number Birth date Request Win/Loss Statement for Tax Year Ending Signature Date REQUESTS MAY BE SENT TO Please send records to GREEKTOWN CASINO ATT. AUDIT DEPARTMENT 555 E*LAFAYETTE AVE* DETROIT MI 48226 Legal Copy Services Inc* PO Box 2845 Grand Rapids MI 49501 OR FAXED TO 313-961-3007 FOR SECURITY PURPOSES A COPY OF YOUR DRIVER S LICENSE OR STATE ID MUST BE INCLUDED WITH ANY REQUEST. All information requested on this form must be filled out completely. Forms not completely filled out will not be honored* Allow four weeks for processing* Signing this form expresses a formal request for this information* Requested information will be sent to the address shown on this request. Greektown Casino assumes no responsibility for the accuracy of the information provided* Greektown Casino assumes no responsibility for information lost in the mail* Greektown Casino Audit Use Only Date Received Processed By Processing Completed Date. AUDIT DEPARTMENT 555 E*LAFAYETTE AVE* DETROIT MI 48226 Legal Copy Services Inc* PO Box 2845 Grand Rapids MI 49501 OR FAXED TO 313-961-3007 FOR SECURITY PURPOSES A COPY OF YOUR DRIVER S LICENSE OR STATE ID MUST BE INCLUDED WITH ANY REQUEST. All information requested on this form must be filled out completely. Forms not completely filled out will not be honored* Allow four weeks for processing* Signing this form expresses a formal request for this information* Requested information will be sent to the address shown on this request. All information requested on this form must be filled out completely. Forms not completely filled out will not be honored* Allow four weeks for processing* Signing this form expresses a formal request for this information* Requested information will be sent to the address shown on this request. Greektown Casino assumes no responsibility for the accuracy of the information provided* Greektown Casino assumes no responsibility for information lost in the mail* Greektown Casino Audit Use Only Date Received Processed By Processing Completed Date. AUDIT DEPARTMENT 555 E*LAFAYETTE AVE* DETROIT MI 48226 Legal Copy Services Inc* PO Box 2845 Grand Rapids MI 49501 OR FAXED TO 313-961-3007 FOR SECURITY PURPOSES A COPY OF YOUR DRIVER S LICENSE OR STATE ID MUST BE INCLUDED WITH ANY REQUEST. All information requested on this form must be filled out completely. Forms not completely filled out will not be honored* Allow four weeks for processing* Signing this form expresses a formal request for this information* Requested information will be sent to the address shown on this request. Greektown Casino assumes no responsibility for the accuracy of the information provided* Greektown Casino assumes no responsibility for information lost in the mail* Greektown Casino Audit Use Only Date Received Processed By Processing Completed Date. .

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