![]() All fields are required* All Information Is Required For Faster Service. The information on this form is required for identification and security purposes. ![]() Please ensure your address and other information on your account is correct before sending in your request. All Win/Loss Statements will be mailed to the address recorded on file. Please allow up to 2 weeks for process and delivery. Year s Requested FOR OFFICIAL USE ONLY Date Sent // Sent By WIN / LOSS STATEMENT REQUEST FORM To request a Win/Loss Statement please fill out the following information entirely and return to Players Club or mail/fax to Presque Isle Downs Casino ATTN Win/Loss FAX 81 PO Box 10728 Erie PA 16514 Requests for Win/Loss Statements will be processed in the order in which they are received.
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