Gold Ranch Win-Loss Statement


Please Enter your PlayerID, Birthdate and Win-Loss Period

Win-Loss Period
Gaming Activity - The above information is provided in response to a request by the person shown above. The activity shown above is associated with the player's card only. Hence, no assurance is made that this activity was accumulated by the person named above. The above figure may not be all inclusive of the person's gaming activity and only reflects that information currently available in the Gold Ranch Casino database. Further, the above "Slot or Table Loss" figure may not be an accurate representation of investment.
Tax Form Activity - Original documents were issued to the winning player at the time of the jackpot. The above information is provided as a reference only, as requested by the person above, and is not intended to be used as the substitute tax form reporting gaming winnings.
I agree to the above terms.
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