Mail Request for W2G, 1099, or Win/Loss Statement Form

Sep 19, 2026

A signed W2G, 1099, or Win/Loss Statement Request Form is required for 7th Street Casino to release tax-related reports. Request processing accepts walk-in or phone requests during tax season, and mail requests require notarization. Eligible recipients are 7th Street Casino Players Club Card members with W2G or 1099 gambling winnings. The form collects identifying details, account information, requested tax form type, gaming year, and proof of state/government photo ID, plus a signature and date.

LanguageEnglish

CategoryForms

FormatPDF

Pages4

Reading Time2 min

AccessFree to download

Request Instructions

Eligibility and Processing Timeline

Information Required on the Form

Disclaimer and Signature Requirements

Form Layout (Pages 1-3)

Mail Request Notary Section

Submission Address

Please read the following: In order for 7th Street Casino to release this information, you are required to submit a signed“W2G, 1099, or Win/Loss Statement Request Form”. Only official request forms will be accepted for processing. You are also required to show proper approved photo identification before receiving the requested forms. You are required to obtain a notary public before mailing the form back to 7th Street Casino for processing. It will take approximately 10 business days to submit either walk-in or phone requests. (only during tax season) Please note: The tax statement request is only for 7th Street Casino Players Club Card Members and those individuals who had a W2G or 1099 gambling winnings. For more information regarding the claiming and filing of gambling winnings, guests are encouraged to contact the IRS or their tax advisor. What information is needed to be completed on the form? 1. Name-First and Last name. Printed legibly. One form per customer 2. Social Security Number-the Social Security number of the person requesting the tax statement (not-applicable if a 1042-S is being requested) 3. Mailing Address-to verify that the information in our system is correct 4. City/State/Zip Code 5. Telephone number 6. Players Club Account Number 7. Date of Birth-the birth date of the person requesting the form. This allows us to verify the correct information 8. Tax Forms requested-W2G, Win/Loss Statement, 1099. Indicate the gaming year and the type of tax statement you are requesting. The release statement must be signed by the account holder in order to process 9. For mail in requested forms-You are required to obtain a notary public before mailing the form back to 7th Street Casino. 10. Copy of State/Gov’t Issued ID. If you have any questions, please call 7th Street Casino at 913-344-7588. Page 1 of 3 Request for W2G, 1099, or Win/Loss Statement Form Requested: W2G (Jackpot won) 1099 (Promotional winnings) Win/Loss (coin in/coin out) 1042-S (foreign person jackpot won) Year Requested: Name: _______ __ ___________ Lucky 7 Club Account \#: Phone \#: Date of Birth: Current Address: _________ City, State, Zip Code: ___ State Issued ID\#: State: Social Security \#: Please read this important disclaimer: The information provided in these reports is an estimate only, and should not be relied upon for tax purposes. Estimates of slot machine activity is based upon electronically recorded data, which may not be reliable due to various factors, including the fact that we cannot verify either that a player uses his or her player’s card at all times or that the recorded activity only represents activity of the registered cardholder. We wish to emphasize that it is the responsibility of each player to maintain accurate records of his or her own play. However, we are pleased to provide this information to you, our valued customer, with the hope that it will assist you in corroborating your own record of play. __________________________________ _____________ _____ _ Signature Date Page 2 of 3 This section is for mail request only and for the public notary: In Witness whereof, I have executed this request at, , City State On the day of , 20 . Only you as the Account Holder may receive or request a W2G, 1099, or Win/Loss Statement. Any Win/Loss Statement provided to you shall be mailed back to you. Your signature on the Request Form must be notarized and you are required to provide a copy of a valid State or Government issued photo ID acceptable to 7 th Street Casino in its sole and absolute discretion in order to receive a copy of the W2G, 1099, or Win/Loss Statement. SUBSCRIBED AND SWORN TO before me The day of , 20 NOTARY PUBLIC __________________________________ ___________________ Patron Signature Date This form may be submitted by mail to: 7 th Street C

FAQs

Who is eligible to request the W2G, 1099, or Win/Loss Statement form?

Only 7th Street Casino Players Club Card members and individuals who had W2G or 1099 gambling winnings are eligible to request these tax statements.

What key information must be completed on the request form?

The form requires the requester’s name, Social Security number (unless requesting 1042-S), mailing address, city/state/zip, telephone number, Players Club account number, date of birth, the tax forms requested (including gaming year and statement type), and a copy of state/government issued photo ID.

What additional step is required for mailed form requests?

Mail requests must be notarized by a public notary before being mailed back to 7th Street Casino for processing.

Sep 19, 2026

Upload by Margaret