Win/Loss Statement Request Form
I request a Win/Loss statement to be mailed to me at the address below.
Win/Loss Statements are now available by login into “My World” at
www.mohegansunpocono.com or you can stop at the players club booth located in the valet
entrance to print your Win/Loss Statement. Please print legibly to help expedite processing of your
request.
Current Tax Year Win/Loss Statements are not available or processed until after the end of the
calendar year.
TAX YEAR _____________
Please check one:

Casino Patron
 Racing Patron
Patron Number: ______________
Last Name: ______________________ First Name: ________________
Street Address: ____________________________________________
City/State/Zip: _______________________/_______/_____________
Phone: (______) _________-___________
Social Security Number: _______ -_______-____________
“U.S. Residents Only”
Date of Birth: _____/______/______
Signature: _________________________________ DATE: _____/______/______
Please return to:
Mohegan Sun Pocono
1280 Highway 315
Wilkes-Barre, PA 18702
Attention: Operational Accounting Department
If additional information is needed or to check the status, call (570) 831-2100 or
1-888-946-4672. Please allow 5 days for your request to be processed.
RETURN BY FAX: (570) 831-3541
Thank you for playing at Mohegan Sun Pocono. We hope to see you back soon!