Prize Claim Form

lottery claim form
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4 Mail form with original ticket attached to the address above 5 Winner Claim Form Substitute W-9 Yes No ☐ ☐ Are you a Lottery Retailer? ☐ ☐ Are

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 Download Forms ; Payees Receipt, Download ; Nominee Form , Download ; Agency Prize, Download ; Prize Voucher , Download

dhan kesari lottery result dhan kesari Where do I claim my prize? · Download and print a Claim Form: or · Visit a PA Lottery retailer and ask for a Claim Form · Visit a PA Lottery A for myself as the sole winner B as a member of the winning group designated on the attached IRS Form 5754