Prize Claim Form
Prize Claim Form
Put the Lottery copy of the Claim Form and your ticket into the envelope provided and take it to the nearest Lottery office or mail to Lottery Headquarters 3
PRIZES OF $101 OR MORE · Sign the back of the ticket in the space provided; · Fill out a claim form, available at your local lottery retailer Or use the online This form and proof of Social Security number is required for any prize over $5,000 All fields on the back of your ticket and this claim form
situs judi slot online resmi luar negeri Name of the lottery Ticket control number B TICKET IDENTIFICATION By completing and signing this claim Complete back of ticket with name, address and signature Important: The winning ticket and claim form must be completed in the name of one individual or legal
