Email
This field is for validation purposes and should be left unchanged.
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
myViejas #
Email
Phone
Date of Birth*
MM slash DD slash YYYY
Last 4 SSN #
Country Identification Issued
State Identification Issued
Identification #*
Identification Expiration
Mail Preference
Win/Loss Statement
- 2025
- 2024
- 2023
Tax Forms
- 2025
- 2024
- 2023
Terms*
- I declare under the penalty of perjury that I am the person about whom I am requesting records. I understand that any falsification of this statement may be punishable under the laws of the Viejas Band of Kumeyaay Indians and/or the United States.
- I understand that it may take up to 5 business days to process my request

Viejas Win/Loss Statement Request Form