Choctaw Win Loss Form PDF Details

Engaging in gaming activities at casinos can be both thrilling and, when it's time to reconcile with Uncle Sam, potentially complicated. For patrons of the Choctaw Casinos, the annual ritual of accounting for wins and losses is made easier with the Choctaw Win/Loss Statement or Tax Information Request Form. This form serves as a crucial tool for individuals seeking to report their gambling outcomes accurately on their tax returns. Required by players to fill out meticulously, the form asks for personal identification information alongside Players Club Card number—a testament to the blend of entertainment and financial diligence necessitated by casino gaming. Moreover, the form accommodates requests for W2G and 1099 documents, essential for those with significant wins, post-February 1st of the following tax year. The process is clearly outlined, directing patrons to send their completed forms to the Choctaw Nation of Oklahoma’s Finance Department, thereby underscoring the tribe's sovereignty and the operations' integration within these indigenous territories. By signing the document, players not only affirm the veracity of their provided information but also agree to a comprehensive release, protecting the casino from potential litigation arising from this disclosure. This legal choreography, balanced delicately on the axis of entertainment and responsibility, encapsulates the complexity of modern casino gaming where the thrill of victory and the agony of accounting converge.

QuestionAnswer
Form NameChoctaw Win Loss Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other nameschoctaw win loss, choctaw win loss statement, slots play choctow, 7761 7606 win

Form Preview Example

Please Return form to: Choctaw Casino

Attention: Cage Accounting 3400 Choctaw Rd

Pocola, Ok 74902 Phone: 918-436-7761 Fax: 918-436-7606

Win/Loss or Tax Information Request Form

Name

 

 

/

 

 

 

 

 

Players Club Card #

 

 

 

 

 

 

 

 

Last Name

 

 

 

First Name

 

 

 

 

 

 

 

 

Social Security Number

 

 

 

 

 

Date of Birth

 

/

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

Month

 

Day

 

 

 

Year

Mailing Address

 

 

 

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

Street Address or P.O. Box

 

 

 

 

Apartment Number

City

 

 

 

 

 

 

 

 

State

 

 

 

Zip

 

 

 

 

Telephone

 

 

 

E-Mail if applicable

 

 

@

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please provide me with a statement of my activity for the tax year (s):

 

 

 

 

 

 

 

 

The following document (s):

(Please Check):

 

 

Win/Loss Statement

W2G

 

 

 

 

 

 

1099's can be requested after February 1st for the previous tax year. All requests must be sent to: Choctaw Nation of Oklahoma Finance Department

Attn: Stacey Workman P.O. 1210 Durant, OK 74701

I, ________________________________________,hereby certify that the information and statements contained herein are true and correct. I hereby

(i.e.. Jane Doe)

authorize Choctaw Casinos to provide me with the above checked statement(s). By signing below, I agree to release Choctaw Casinos, its officers, directors, associates, and agents from any loss, cost, expense (including attorney's fees and costs), damages, liability or claims of any kind. I agree to indemnify Choctaw Casinos from and against any and all suits, causes of action, liabilities, costs, losses, damages, and attorney's fees and costs which I or my spouse, administrators, executors, agents, assignees or any third party may have arising out of or relating to this request.

Please provide a copy of your valid ID and your SSN (TIN) number, what applies

If this Information is not obtained, then the request will not be completed

Sites (Check all that apply-W2G's Only)

Resort

Durant Too

Idabel

Pocola

Pocola Too

McAlester

McAlester Too

Grant

Atoka

BRD

Broken Bow

Broken Bow Too

Stringtown

Stringtown Too

Poteau

Wilburton

Casino Guest' s Authorized Signature

 

Date

 

 

 

Casino Associate Issuing Copies

 

Date

Disclaimer

DO NOT WRITE BELOW THIS LINE. FOR CHOCTAW CASINOS USE ONLY.

Identification Type Provided

Social Security

W -9

Photo Identification

 

Verifier's Signature and Date

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