In the bustling world of casino gaming, understanding the implications of wins and losses becomes paramount, especially when it intersects with tax obligations. Located at the heart of this intersection is the Downstream Casino Win Loss form—a crucial document for anyone engaged in gaming at the Downstream Casino Resort. This form serves as a formal request for a statement that details a player's gaming activity within a specified tax year, providing essential information for accurate tax reporting. To initiate this process, the requester must provide comprehensive personal information, including their name, Players Club Card number, Social Security number, date of birth, contact details, and the specific tax year in question. In addition to the win/loss statement, the form also offers the option to request other tax-related documents such as W2G or 1099 forms, integral for preparing tax returns. Importantly, the form requires the requester to certify the accuracy of the information provided and to authorize the Downstream Development Authority DBA Downstream Casino Resort to release the requested statements. Moreover, by signing the form, the requester agrees to absolve and indemnify the Downstream Casino of any liabilities or claims that might arise from this information exchange. The procedure underscores the necessity of transparency and accuracy in the delicate balance of gaming entertainment and financial responsibility.
| Question | Answer |
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| Form Name | Downstream Casino Win Loss Form |
| Form Length | 1 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 15 sec |
| Other names | downstream win loss ststement, online win loss statement, won loss statement, downstream statement loss |
Please return form to: Downstream Casino Resort Attention Income Audit 69300 East Nee Road Quapaw, OK 74363
Win/Loss or Tax Information Request Form
Name _____________________________ /_________________ Players Club Card # __________________ |
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Last Name |
First Name |
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Social Security Number ___________________________ Date of Birth _________ / _________ / ________ |
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Month |
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Year |
Mailing Address _________________________________________________________ / _______________ |
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Street Address or P.O. Box |
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Apartment Number |
City ____________________________________________ State ___________ Zip ____________________ |
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Telephone _____________________ E‐mail if applicable ________________________________________ |
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Please provide me with a statement of my activity for the tax year: _________ |
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The following document(s): (Please Check): Win/Loss Statement W2G 1099 Gaming
I hereby certify that the information and statements contained herein are true and correct. I hereby authorize Downstream Development Authority DBA Downstream Casino Resort to provide me with the above checked statement(s). By signing below, I agree to release Downstream Development Authority DBA Downstream Casino Resort, its officers, directors, employees, and agents from and against any loss, cost, expense (including attorney’s fees and costs), damages, liability or claims of any kind. I agree to indemnify Downstream Development Authority DBA Downstream Casino Resort 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.
I have executed this request at ________________________________________ , ______________
CityState
on this _______ day of ___________________ , 20_____.
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Guest’s Authorized Signature |
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DO NOT WRITE BELOW THIS LINE. FOR DOWNSTREAM CASINO USE ONLY. |
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Identification Type |
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Insert Verification |
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Verifier’s Signature |
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Social Security |
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Photo Identification |
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Other Identification |
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Notarized |
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