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The Michigan Win Loss Statement form is an essential document for patrons of Grand Traverse Resort and Casinos who wish to obtain their gambling win-loss records. This form is specifically designed for members of the Player’s Club Card, as the casino only tracks play associated with these accounts. To initiate the process, customers must submit a signed request, which can be completed by either individual partners in a marriage using a single form. The request requires personal information, including the patron's name, Player’s Card number, Social Security number, date of birth, and contact details. It is important to note that the win-loss statements are based solely on player tracking information, which reflects only the play associated with the Player’s Card. This means that any play conducted without the card will not be included in the statement. Patrons must also acknowledge that the information may contain estimates and may not fully represent their actual gaming activity. Furthermore, the form includes a release clause, which protects the casino from any claims related to the information provided. To ensure processing, customers must include a copy of their driver’s license or provide their Social Security number. Completed forms can be submitted via mail, email, or in person at the casino, with processing typically occurring after the New Year unless specified otherwise.

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Win Loss Statement Request

In order for Grand Traverse Resort and Casinos to release this information each customer is required to submit a signed request. Husband and Wife may use one form. The win loss statements are only available for Player’s Club Card members. Grand Traverse Resort and Casinos does not track play that is not associated with a customers player’s card account

Please provide me with a Win/Loss Statement for Year (s) _________

Name _________________________________________________

Player’s Card Number: _______________________

SS# ___________________________________________________

Date of Birth: _______________________________

Mailing Address ______________________________________________________________________________________

City/State/Zip: ________________________________________________________________________________________

Phone Number (___) _______________________ Email statement to __________________________________________

By signing below the patron hereby releases Grand Traverse Resort and Casinos, its officers, directors, employees, agents from and against any loss, cost, expense (including attorney’s fees and costs, damages, liability or clams of any kind. Additionally, patron hereby agrees to indemnify Grand Traverse Resort and Casinos for, from and against any loss, cost, expense (including attorney’s fees and costs), damages, liability or claims of any kind related to releasing this information. The undersigned acknowledges that the information being provided is based on player tracking information which includes only the play when the undersigned’s players card was connected to the system, and may not accurately reflect the amount of the undersigned’s play since the undersigned can play when the card is not connected to the system and is derived from a system that does not verify the identity of the person using the player card and may include estimated amounts to correct human error in inputting information.

Account Holder’s Signature ______________________________ Date____________________

***********************************************************************************************

Please provide me with a Win/Loss Statement for Year (s) _________

Name _________________________________________________

Player’s Card Number: _______________________

SS# ___________________________________________________

Date of Birth: _______________________________

Mailing Address ______________________________________________________________________________________

City/State/Zip: ________________________________________________________________________________________

Phone Number (___) _______________________ Email statement to ___________________________________________

By signing below the patron hereby releases Grand Traverse Resort and Casinos, its officers, directors, employees, agents from and against any loss, cost, expense (including attorney’s fees and costs, damages, liability or clams of any kind. Additionally, patron hereby agrees to indemnify Grand Traverse Resort and Casinos for, from and against any loss, cost, expense (including attorney’s fees and costs), damages, liability or claims of any kind related to releasing this information. The undersigned acknowledges that the information being provided is based on player tracking information which includes only the play when the undersigned’s players card was connected to the system, and may not accurately reflect the amount of the undersigned’s play since the undersigned can play when the card is not connected to the system and is derived from a system that does not verify the identity of the person using the player card and may include estimated amounts to correct human error in inputting information.

Account Holder’s Signature ______________________________

Date____________________

Only complete official request forms will be accepted for processing. (Must include a copy of Driver’s License OR enter your social security number for verification purposes or request (s) will not be processed). Statements will be processed after the first of the New Year unless specifically requested. Return form via mail, email or drop off at either Casino.

Grand Traverse Resort and Casinos

 

Attn: Shirley Shananaquet, CMP Administrator

 

7741 M-72 East, Williamsburg, MI 49690

 

Office 231-534-8840

email: [email protected]

Form Specifications

Fact Name Details
Purpose This form is used to request a Win/Loss Statement from Grand Traverse Resort and Casinos.
Eligibility Only Player’s Club Card members can request a Win/Loss Statement.
Joint Requests Husbands and wives may submit a single form for their request.
Tracking Limitations The casino does not track play that is not associated with a customer’s Player’s Card account.
Signature Requirement A signed request is mandatory for processing the Win/Loss Statement.
Processing Time Statements are processed after the first of the New Year unless a specific request is made.
Verification A copy of a Driver’s License or Social Security number is needed for verification.
Submission Methods Forms can be submitted via mail, email, or in person at the casino.
Governing Law This form complies with Michigan state law regarding gambling and casino operations.
Contact Information Requests can be directed to Shirley Shananaquet at 231-534-8840 or via email.

Michigan Win Loss Statement: Usage Guidelines

Filling out the Michigan Win Loss Statement form is a straightforward process. By following the steps below, you can ensure that your request is completed accurately and submitted properly. Once you have filled out the form, you can send it via mail, email, or drop it off at the designated location.

  1. Begin by entering the year(s) for which you are requesting the Win/Loss Statement in the designated space.
  2. Provide your full name as it appears on your Player’s Club Card.
  3. Write down your Player’s Card Number in the specified area.
  4. Enter your Social Security Number (SS#) for verification purposes. If you prefer, you can also include a copy of your Driver’s License instead.
  5. Fill in your date of birth in the format requested.
  6. Complete your mailing address, ensuring that all fields are filled out accurately.
  7. Provide your city, state, and zip code in the appropriate sections.
  8. Enter your phone number, including the area code, in the designated space.
  9. If you would like to receive the statement via email, write down the email address where you want it sent.
  10. Sign and date the form to acknowledge the release of information and indemnification agreement.

Once you have completed the form, make sure to review it for any errors. Official request forms must be submitted with the required verification to be processed. After submission, your request will be handled accordingly, and you will receive your Win/Loss Statement as requested.

Your Questions, Answered

What is the Michigan Win Loss Statement form?

The Michigan Win Loss Statement form is a request document that allows players at Grand Traverse Resort and Casinos to obtain a summary of their gambling activity for tax purposes. This statement is only available to members of the Player’s Club Card and reflects the wins and losses associated with their card usage.

Who can request a Win Loss Statement?

Only customers who are members of the Player’s Club Card can request a Win Loss Statement. Additionally, a husband and wife can submit a single form to request statements for both individuals, provided they are both members of the Player’s Club.

What information is required to complete the form?

To complete the form, you need to provide your name, Player’s Card number, Social Security number or a copy of your Driver’s License, date of birth, mailing address, phone number, and the years for which you are requesting the statement. You must also include your signature to authorize the release of this information.

How is the Win Loss Statement processed?

Once you submit the completed form, it will be processed after the first of the New Year unless you specify otherwise. You can return the form via mail, email, or drop it off at either casino location. Ensure that you include all required information to avoid delays in processing.

What should I be aware of regarding the accuracy of the Win Loss Statement?

The Win Loss Statement is based on player tracking information and only reflects activity when your Player’s Card was in use. It may not accurately represent your total gambling activity, as play without the card will not be tracked. Additionally, the system may include estimates to correct human errors in data entry.

Common mistakes

  1. Incomplete Information: Failing to fill out all required fields, such as name, player’s card number, or date of birth, can lead to processing delays.

  2. Missing Signature: Not signing the form will result in the request being rejected. A signature is mandatory for processing.

  3. Incorrect Social Security Number: Entering an incorrect SS# can prevent verification and halt the processing of the request.

  4. Omitting Verification Documents: Forgetting to include a copy of the driver’s license or failing to provide the SS# for verification will lead to rejection.

  5. Incorrect Mailing Address: Providing an incorrect or incomplete mailing address can result in the statement not reaching you.

  6. Failure to Specify Year(s): Not indicating the year(s) for which the win/loss statement is requested will cause confusion and delays.

  7. Not Following Submission Guidelines: Ignoring the instructions for returning the form via mail, email, or drop-off may result in processing issues.

  8. Not Allowing Processing Time: Expecting immediate processing without understanding that statements are typically processed after the New Year can lead to frustration.

Documents used along the form

When dealing with the Michigan Win Loss Statement form, several other documents and forms often accompany it. Each serves a specific purpose and helps streamline the process of obtaining your win/loss information from Grand Traverse Resort and Casinos. Understanding these documents can make your experience smoother and more efficient.

  • Player’s Club Card Application: This form is essential for those who wish to join the Player’s Club. It collects personal information and establishes your eligibility to earn rewards and track your play.
  • Player’s Club Terms and Conditions: This document outlines the rules and benefits associated with the Player’s Club membership. It’s important to read and understand these terms to know what you can expect from your membership.
  • Request for Player Account Information: If you need details about your player account, this form allows you to formally request that information. It ensures that you receive accurate data regarding your gaming activities.
  • Tax Form W-2G: This tax form is issued for certain gambling winnings. If you win a significant amount, you may receive this form, which is necessary for reporting your gambling income on your tax return.
  • Identity Verification Form: Sometimes, additional verification is required to process requests. This form helps confirm your identity, ensuring that sensitive information is securely handled.
  • Consent to Release Information: This document allows the casino to share your gaming information with third parties, such as tax professionals or financial advisors, if you choose to do so.
  • Account Closure Request: If you decide to close your Player’s Club account, this form facilitates that process. It ensures that all your personal information is handled appropriately and that you receive any remaining benefits.
  • Complaint Resolution Form: In the event of a dispute or issue with your account, this form provides a structured way to express your concerns and seek resolution from the casino management.

By familiarizing yourself with these forms, you can navigate the process of obtaining your win/loss statement more effectively. Each document plays a crucial role in ensuring that your gaming experience remains enjoyable and transparent. Be sure to have the necessary forms ready to make your request as seamless as possible.

Similar forms

  • Tax Return Statement: Similar to the Win Loss Statement, a tax return statement summarizes an individual's income and losses over a specific period. Both documents require accurate personal information and can impact financial reporting.
  • Profit and Loss Statement: This document is used by businesses to summarize revenues and expenses. Like the Win Loss Statement, it provides a clear view of financial performance, though it pertains to business rather than personal gambling activities.
  • Bank Statement: A bank statement details all transactions in a bank account over a certain period. Both documents serve as records of financial activity and require personal identification for verification.
  • Credit Card Statement: This statement outlines all transactions made with a credit card, similar to how the Win Loss Statement tracks gambling activity. Both documents can be used to assess spending habits.
  • Gambling Loss Report: This report is specifically designed for gamblers to document their losses. Like the Win Loss Statement, it is often used for tax purposes and requires detailed personal information.
  • Financial Disclosure Statement: This document is often required in legal proceedings to disclose an individual's financial status. Similar to the Win Loss Statement, it requires thorough personal information and can affect financial decisions.
  • Income Statement: Commonly used in business, this document summarizes revenues and expenses over a period. It is similar to the Win Loss Statement in that both provide a snapshot of financial performance.
  • Personal Financial Statement: This document outlines an individual's assets, liabilities, and net worth. Like the Win Loss Statement, it requires personal details and is often used for loan applications.
  • Expense Report: An expense report tracks expenditures over a specific time. Similar to the Win Loss Statement, it provides a summary of financial activity and often requires receipts or documentation for verification.
  • Loan Application: When applying for a loan, individuals must often provide detailed financial information. This process is akin to the Win Loss Statement, as both require personal data and financial history to assess eligibility.

Dos and Don'ts

When filling out the Michigan Win Loss Statement form, it is important to follow specific guidelines to ensure your request is processed smoothly. Here are some do's and don'ts to keep in mind:

  • Do ensure that you are a Player’s Club Card member. Only members can request a win/loss statement.
  • Do provide accurate personal information, including your full name, Player’s Card number, and Social Security number.
  • Do sign the form. Your signature is necessary to release the information and to acknowledge the terms outlined in the form.
  • Do include a copy of your Driver’s License or provide your Social Security number for verification purposes.
  • Don't forget to specify the year(s) for which you are requesting the win/loss statement. Leaving this blank may delay processing.
  • Don't submit the form without checking for errors. Mistakes can lead to rejection of your request.
  • Don't assume that your statement will be processed immediately. Statements are typically processed after the first of the New Year unless otherwise requested.
  • Don't send the form without ensuring it is the official request form. Only complete forms will be accepted for processing.

Misconceptions

  • Misconception 1: Anyone can request a Win Loss Statement.
  • Only members of the Player’s Club Card can request a Win Loss Statement. If you do not have a Player’s Card, you will not be able to obtain this information.

  • Misconception 2: Couples can’t use the same form.
  • Husbands and wives can indeed use one form to request their Win Loss Statement. This makes it easier for couples who share an account.

  • Misconception 3: The casino tracks all play, regardless of card use.
  • The casino only tracks play associated with a customer’s Player’s Card account. If you play without your card, that play will not be included in your statement.

  • Misconception 4: The Win Loss Statement is always accurate.
  • The statement is based on player tracking information, which may not reflect all of your play. If your card was not connected to the system during your play, those amounts will not be included.

  • Misconception 5: Submitting the form is enough to get the statement.
  • You must also provide a copy of your Driver’s License or your Social Security number for verification. Incomplete requests will not be processed.

Key takeaways

Key Takeaways for Filling Out the Michigan Win Loss Statement Form:

  • Ensure you are a Player’s Club Card member, as only members can request a Win/Loss Statement.
  • Both spouses can use a single form to request their statements.
  • Complete all required fields, including your name, Player’s Card number, and Social Security number for verification.
  • Sign the form to release Grand Traverse Resort and Casinos from any claims related to the information provided.
  • Submit the completed form with a copy of your Driver’s License or provide your Social Security number; incomplete forms will not be processed.
  • Return the form via mail, email, or in person at the casino, and note that statements are typically processed after the New Year.