[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-302834-105":53,"doc-detail-302834-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","win-loss-request-form-action","Win-Loss-Request-Form - Action","","Win/Loss Request Form to estimate play activity based on carded gaming activity. Collects requester identity details, tax year requested, address, contact information, date of birth, and a CQ Rewards number, plus the preferred delivery method with up to four weeks processing time. Includes a release and indemnification section granting DraftKings at Casino Queen access to the provided information, disclaimers about accuracy, and requires a signature and a copy of valid government-issued ID.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/win-loss-request-form-action/302834/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/win-loss-request-form-action/302834.png","ImageObject",442,249,{"name":88,"@type":89},"Mason","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-09-25","2026-09-19",true,{"@type":98,"interactionType":99,"userInteractionCount":9},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What information is required to submit a win/loss request?","Question",{"text":108,"@type":109},"You must provide required personal details including name, address, date of birth, and CQ Rewards number, along with the tax year requested and your preferred delivery method.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"How do I choose the delivery method for my requested information?",{"text":113,"@type":109},"Select one option: in-person pickup, mail a copy to the provided address (with a self-addressed stamped envelope), or email a copy to the email address listed on the form.",{"name":115,"@type":106,"acceptedAnswer":116},"Why is my signature required and what else must I include?",{"text":117,"@type":109},"Your request cannot be processed without your signature. You must also include a copy of a valid, government issued ID with the form.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},302834,1790295744,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":79,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":9,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":4},5909887256941,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Request Form  \n(Document estimating play activity based on carded gaming activity)  \nPlease print all information clearly.  \n*Required fields  \nType of Request:  \nW2-G  \nWinLoss  \nTax Year Requested:    \n\n| *First Name | *Middle Name | *Last Name |  |\n| --- | --- | --- | --- |\n| *Street Address | *City | *State | *Zip Code |\n| *Date of Birth (mm/dd/yyyy) | *CQ Rewards Number |  |  |\n\nPhone Number Email Address  \nPreferred Delivery Method (allow up to 4 weeks for processing)  \nPick up in person from Player’s Club  \nMail a copy to the address listed on this form (must provide self addressed stamped envelope)  \nEmail a copy to the email address listed on this form  \nRelease and Indemnification  \nI hereby request that DraftKings at Casino Queen provide me with the information requested above. In consideration of this information, I hereby release Casino Queen, Inc. and its parent and affiliated companies, and all of their respective officers, directors, employees, from any and all claims arising from or relating to the information and its release and further agree to indemnify and hold these entities and persons harmless from any such claims. I understand that the requested information is generated from internal systems and is not intended to be or take the place of my own records of my own gaming activity. Casino Queen, Inc. makes no representation or warranty, express or implied, as to the accuracy of this information.  \nSignature (Required):   Date:    \nYour request cannot be processed without your signature. You must include a copy of a valid,  \ngovernment issued ID with this form.  \nEmail [winloss@dkatcq.com](winloss@dkatcq.com) or call 618-261-8002 with any questions.  \nMail completed form & self-addressed stamped envelope to:  \nOr email completed form to:  \nDraftKings at Casino Queen Attn: Win/Loss Requests 200 South Front Street  \nEast St. Louis, IL 62201  \n[winloss@dkatcq.com](winloss@dkatcq.com)  \nCopyright © 2022 DraftKings at Casino Queen. All rights reserved. Self-excluded or evicted persons are subject to arrest and prosecution for trespassing by entering DraftKings at Casino Queen’s premises. Must be 21 years of age or older to enter casino. If you or someone you know has a gambling problem, crisis counseling and referral services can be accessed by calling 1-800-GAMBLER (1-800-426-2537) .","cbCaioTsYKha1taf","https://ap.wps.com/l/cbCaioTsYKha1taf","pdf",130010,"English","# Request Details\n## Required Information\n## Delivery Method\n# Release and Indemnification\n## Signature and ID Requirements\n## Submission Information","[{\"question\":\"What information is required to submit a win/loss request?\",\"answer\":\"You must provide required personal details including name, address, date of birth, and CQ Rewards number, along with the tax year requested and your preferred delivery method.\"},{\"question\":\"How do I choose the delivery method for my requested information?\",\"answer\":\"Select one option: in-person pickup, mail a copy to the provided address (with a self-addressed stamped envelope), or email a copy to the email address listed on the form.\"},{\"question\":\"Why is my signature required and what else must I include?\",\"answer\":\"Your request cannot be processed without your signature. You must also include a copy of a valid, government issued ID with the form.\"}]","Win-Loss-Request-Form - Action | PDF",1789797460]