Win-Loss Statement Request

Upon your request, Northern Waters Casino will supply you with a Win-Loss Statement. We honor your privacy and will accept only personal requests only from individual members. Please submit this request form and we will contact you personally for verification of identity.

First Name *

Last Name *

Email *

Phone

Address

City *

State *

Zip/Postal Code *

Date Of Birth *

Player's Club Number *

Year Requested *

Please Answer *
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