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Gambling Win Loss Statement | Riviera Casino & Hotel
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Win/Loss Request Form
Club Riviera Account #
*
Name
*
First
Last
Date of Birth
*
MM
DD
YYYY
Phone
*
Email
*
Tax Years Requested
*
2012
2011
Please indicate your preference:
Please mail the letter to the address on file at the Riviera Casino & Hotel. To verify the mailing address we have on file, please call 800.637.5687
Please e-mail a pdf letter to the e-mail address noted above
Please use the e-mail address above to replace any previous e-mail address that may have been on file at the Riviera Casino & Hotel. I understand that this constitutes my agreement to receive promotional offers from the Riviera Casino & Hotel (Opt in not mandatory)
Please be advised that the Riviera Casino & Hotel sends this information as a courtesy only, and not as a legal document. If submitting to your tax consultant, or using for tax purposes, this letter represents only the estimated net results. All net results are based on observation and estimates by our gaming personnel and are not the result of our accounting system for recording revenue. Slot net win/loss information is the result of total coin-in minus total coin-out while playing with the slot card. Slot net win/loss information given in this letter is traced through your slot card. The net results provided do not include any activity at Riviera Black Hawk Casino nor does it include any tournament or drawing winnings, race and sports book or poker play.
Please mail my Win/Loss Statements automatically each year to the address on file at Club Riviera
If you are requesting information regarding a W-2G or 1099, please call the Riviera Casino Audit Department at 1-702-794-9234.
I agree to the terms and conditions set forth