w-6 Player Personal Form

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PLAYER PERSONAL FORM

First Name Last Name

Social Security Number Date of Birth / /

Address

City State Zip Code

Phone Number Cell Phone Number E-mail Address

Spouse’s Name (if applicable)

Phone Number Cell Phone Number E-mail Address

Emergency Contact Name Phone Number

Agent’s Name

Address

City State Zip Code

Phone Number Cell Phone Number E-mail Address

Bank Name

Address

City State Zip Code

Direct Deposit Yes no Deposit Amount

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