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Win/Loss or Tax Information Request Form
WIN/LOSS OR TAX INFORMATION REQUEST FORM
Players Club Card Number
Date of Birth
Please provide me with a statement of my activity for the tax year:
I hereby certify that the information and statements contained herein are true and correct. I hereby authorize Indigo Sky Casino and Outpost Casino to provide me with a Win/Loss Statement for the tax year noted above. By checking here and submitting this form, I agree to release Indigo Sky Casino and Outpost Casino, its officers, directors, employees and agents from and against any loss, cost, expense (including attorney fees and costs), damages, liability or claims of any kind. I agree to indemnify Indigo Sky Casino and Outpost Casino 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.
*Win/Loss statements may not be accurate, only records carded play
Check here to affirm the above
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