Tax Form Request

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MonthDayYear
Date
Lucky Star Rewards Account Number
Last 4 Tax ID
Calendar Year(s) Requested*
I am requesting that Lucky Eagle Casino & Hotel (“LEC&H”) provide me with my tax figures for the year(s) listed above.

I understand the information is being provided to me based on the data available to LEC&H.

Records are not subject to audit or review and as a result, LEC&H is unable to make any assurances as to the accuracy or completeness of the reported amounts. LEC&H strongly recommends you consult your tax advisor for any questions or reporting of these figures related to income tax filings.
I confirm that I have read and understand the statement above

I confirm that I have read and understand the statement above
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