Win/Loss Statement Requests
Simply follow the instructions to download and complete the form provided.
A completed request form and copy of a valid government issued photo I.D. may be submitted for processing in one of the following ways:
1. In Person at the Cashier's Cage.
2. Mail to address:
Casino Queen, Inc.
Attn: Win/Loss Requests
200 S. Front Street
East St. Louis, IL 62201
3. Email a copy to firstname.lastname@example.org
Please allow up to 4 weeks for processing. A valid, government issued photo I.D. must be submitted with a completed form. Any forms submitted without a copy of a valid, government issued photo I.D. will not be accepted.
Win/Loss Request Form