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Winstar Win Loss Form
State: ___________ Zip: ______________
Phone Number: ___________________________
Fax Number: _________________________
Email Address: _______________________________________________________________________
WinStar World Casino and Resort is a governmental enterprise of the Chickasaw Nation, (“Nation”), a federally
recognized sovereign Indian tribe.
By completing this form, I am requesting a cumulative Win/Loss amount for gaming activity at the WinStar
World Casino and...
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