Win-Loss Statements - Tiverton Casino Hotel

Win/Loss

Please use the form below to receive your win loss statement. For security purposes, your win loss statement will be mailed to the address we have on file through your players club account.

Your Name*
First Last
Rewards Card Account Number*
Your Phone Number*
Date of Birth*
MM
DD
YYYY
Send statement for the year ending*
Signature*

Tiverton Casino Hotel requires patrons to complete a Win Loss Form before the information may be released. You may also visit the Players Club in person to obtain and fill out this form.

PLEASE NOTE: 2018 statements will not be available until January, 2019.

If you would like to download and mail your statement, please mail to the attention of:

Tiverton Casino Hotel
Attn: Marketing Dept. Denitsa Pasco (Win/Loss)
777 Tiverton Casino Blvd
Tiverton, RI 02878

Please present this request to Tiverton Casino Hotel Players Club (Casino Floor) with current and valid identification.
If this request is not presented in person, request must be notarized.

Incomplete requests will be delayed pending missing information or rejected.
Tiverton Casino Hotel will mail the requested statement within two weeks of receipt.

Thank you.