Win Loss Ameristar PDF Details

When you're playing casino games, it's always important to keep track of your wins and losses. The Win Loss Ameristar form is the perfect tool for doing just that. This form is used to record information about each of your casino gaming sessions, including the date, time, type of game played, and amount won or lost. It's a great way to track your progress and make sure you're being smart with your money while gambling.

Here is the details about the PDF you were looking for to fill in. It will tell you how long it will require to complete win loss ameristar, what fields you will have to fill in, and so on.

QuestionAnswer
Form NameWin Loss Ameristar
Form Length2 pages
Fillable?Yes
Fillable fields13
Avg. time to fill out3 min 10 sec
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Form Preview Example

W-2G /WIN-LOSS REQUEST FORM

Please print clearly.

__________________________________________________________________________________

FIRST NAMEMIDDLELAST

_______________________________________________________________________________________________________________

STREET ADDRESSCITYSTATE ZIP CODE

_______________________________________________________________________________________________________________

SOCIAL SECURITY NUMBERPLAYERS CLUB CARD #

_______________________________________________________________________________________________________________

PHONE NUMBER

E-MAIL ADDRESS

TAX YEAR REQUESTED

PLEASE CHECK ONE OR BOTH OF THE FOLLOWING:

Win-Loss Statement: A single page letter showing estimated play activity (wins or losses) based upon observable and/or carded gaming activity.

W-2G Data: If you have won one or more jackpots exceeding $1,200 a report summarizing these winnings is available.

Request Agreement

I certify that the statements contained herein are true and correct, and I hereby request that the Ameristar property indicated below provide me with the information requested above. I understand that it is my own responsibility to maintain accurate records of play, and that the information I am requesting consists of estimates only and may not be appropriate for income tax reporting. In consideration of my receipt of this information, I agree to indemnify and hold harmless Ameristar Casinos, Inc., its subsidiaries and affiliates (including the Ameristar property indicated below), and their respective officers, directors, employees and agents from any and all claims, suits, causes of action, liabilities, costs, losses, damages, and expenses (including attorney’s fees and costs) which I, or my administrators, executors, agents, successors, heirs or assigns, or any third party, might have or incur as a result of, or in any way relating to, my receipt and/or use of the information.

SIGNATURE (REQUIRED) TODAY’S DATE

If the Account Holder does not present this request in person, the Account Holder’s signature must be notarized.

SUBSCRIBED AND SWORN TO before me

the ______ day of ____________________, 20_____.

______________________________________

NOTARY PUBLIC

Please completely fill out the request form and return it to:

For Internal Use Only:

Ameristar Casino Black Hawk Attn: CASINO SERVICES

Rec’d:__________ / Comp: ___________ By:__________

111 Richman St, PO Box 45

F M P

Black Hawk, CO 80422

 

Fax: 720 946 4030

 

 

 

___________________________________________________________________________________________________

AMERISTAR CASINO BLACK HAWK – CONFIDENTIAL

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