lottery prize claim form
No claim form is required. lottery delaware state lottery 1575 mckee road claim form suite 102 d window ___ _ dover, delaware 19904 d mail please print below last name street first name initial city state zip code mo i i day yr - m f i i date of birth sex social security number i i i mo day yr area code telephone number claim date prize claimed i To claim Scratch Game prizes or Lotto Game prizes of $600 - $50,000, you may present a completed claim form in person at any Lottery office or you may mail a completed claim form and ticket to the Minnesota State Lottery, P.O. Complete the Prize Claim Form F Section 1: Fill in your personal details. Call 1-800-LOTTERY(568-8379), or visit any Lottery District Office to reques t a Multiple Ownership Claim form for group players (less than 100) sha ring prizes of $1,000,000, or mo re. For prizes of $601 or more, you will need to send a completed claim form with the winning ticket. and process a prize claim without the number due to the application of the Virginia Lottery Law and the regulations adopted thereunder (Va. Code § 58.1-4000 et seq. 3.orm. PRIZE CLAIM FORM CLAIM ID # Mail To: WEST VIRGINIA LOTTERY PO BOX 2913 CHARLESTON, WV 25330 Offices in Charleston and Weirton Open 8 AM to 5 PM (M-F) 4. Complete this form. LOTTERY USE ONLY TOTAL PRIZE $ CLAIM NUMBER _____ WINNER CLAIM FORM Include your ORIGINAL winning Post office box 6073 Helena, mt 59604- 6073 Phone: 406.444.5825 Fax: 406.444.5830 montanalottery.com A completed prize claim form is required for claims $600 and over Claim form is not legible This includes unreadable handwriting and not leaving spaces between words. For Video Lottery prizes, only the 8% state tax withheld. Add the date and place your e-signature. Your time is valuable to us; please call ahead so that the Lottery can prepare for your arrival. at your National Lottery retailer or by calling the National Lottery For prizes of $1,500 and more, Oregon state tax . First and last names are swapped On the claim form, write your last name then your first name in the name fields. How to Claim - To claim a prize of $600 or more, you can use any of the methods below to claim your winning ticket. Citizenship field is blank W2G. Fill the empty areas; engaged parties names, addresses and phone numbers etc. Claims will no longer be accepted via drop box. If a winner is a non-resident alien, the Lottery is required to withhold 30% federal withholding tax from all prize payments. Claim . Prizes up to Rs. ), as well as the Virginia Debt Setoff Collection Act (Va. Code § 58.1-520, et • Make a copy of the ticket(s) and claim form for your records. The ticket must be completed in the name of one individual or legal entity (i.e., Corporation, Partnership, etc.) Claim Prize - Georgia Lottery Corporation Headquarters (Atlanta, GA) 20 minutes. Payments is the custodian of prize claim records and may be contacted at One Broadway Center, PO Box 7533, Schenectady, NY 12301-7533 or by phone at (518) 388-3370. Alternatively, if you still need to contact the Texas Lottery, then you can call us at 800-375-6886 or email us at customer.service@lottery.state.tx.us. 20 minutes. P.O. Prizes of $600 or more must be redeemed by New Jersey Lottery Claim Form. State 8. Any prize amounts between £100 and £50,000 can be claimed by post. 2. Mail form with your entire ticket to: PO Box 8687, Boise, ID 83707. We reccommend sending tickets through certified mail. Watford. Claim a Prize by Mail. mail to: kentucky lottery corporation claims - dept. Box 7533 Schenectady, NY 12301-7533 Prize Claim Questions: 518-388-3370 Lottery Security: 518-388-3416 Winners should call our office at 444-5825 to schedule an appointment. Prizes Won Online. Sign and date on the Claimant's Signature line. orm. 2) Sign the Claim Form and your ticket. M.I. Visit any authorized Florida Lottery retailer and ask for a Claim Form. Change the blanks with exclusive fillable fields. The Illinois Lottery has introduced e-claims as an option for players to electronically submit winning tickets online to claim a prize. 3. The usual limit for the automatic payment is $600. • you must sign your name on the ticket. ILLINOIS LOTTERY WINNER CLAIM FORM PLEASE CAREFULLY COMPLETE AND PRESENT THIS FORM TO THE NEAREST PRIZE CENTER IN-PERSON OR BY MAIL TO SPRINGFIELD (PO Box 19080, Springfield, IL 62702) WITH A VALID WINNING LOTTERY TICKET (Over $600) If your claim is validated, your check will be made payable to the claimant's name exactly as shown below. When you play online, winnings under $600 are automatically added to your account. (limit of 5 claims per appointment) Claim Prize - Hartsfield-Jackson International Airport North Terminal. Congratulations on winning the Lottery! MANDATORY: To claim a prize of $1,000 or more, you must complete a Lottery Prize Claim Declaration Form (LPCD).This applies to both single and group play wins. How it works Upload the new york lottery claim form Edit & sign lottery form from anywhere Save your changes and share nylottery claim form Rate the lottery claim form ny 4.7 Satisfied 23 votes be ready to get more Create this form in 5 minutes or less Get Form Find and fill out the correct ny lottery online at your National Lottery retailer or by calling the National Lottery Lottery Claim Form - 13 images - lottery application form for funding 2017 pdf hse, ialottery blog hey will i get a tax form from the lottery, il lottery winner claim form 2016 2021 fill and sign, new york take 5 lottery winner, Winners should send their winning tickets, along with a claim form and clear photocopy of valid forms of iedntification to us through the U.S. mail. Send the completed claim form and winning ticket to the Lottery at 711 E. Wells Avenue, Pierre, SD 57501. Payment of prizes of $1 million or more may be delayed for periods of three weeks, or more, from the date of validation of the original winning ticket. Find a Retail Location. No appointments are required. In case of lost W-2G form, call 517-373-6001 and a duplicate W-2G . You may claim your prize by either mailing us your ticket and the CLAIM FORM or stop in to the Idaho Lottery headquarters. City7. Simply type in your information on the form, print it off, then sign and date it. Prizes of $599.99 or less can be redeemed at Lottery retailers. If you have questions, contact the Lottery at 1-800- Must validate ticket for Claimant (ticket owner) and give Claimant the validation receipt. TO CLAIM A PRIZE IN PERSON . Date of Claim (yyyy/mm/dd) Time of Claim (24 hr) Contact ID # ID Type Claimant Information (as shown on government issued ID) Ticket . $1 - $600: may be claimed at a New Mexico Lottery retailer or by mailing to the New Mexico Lottery. All Arizona Lottery retailers will redeem prizes up to $100, and may redeem prizes up to $599. F Section 2: Fill in your bank details. Caribbean Lottery™ By completing and submitting the "Winner Prize Claim Form", you acknowledge and consent to the data practices described in this Statement. 5. The Ohio Lottery issues a W-2G Form to the Winner. Step 3: Identify the Right Winner Claim Form. Fill out a Winner Claim Form. The prize-winner of a lottery shall surrender the prize-winning ticket within 30 days of the draw with all necessary documents. To claim your lottery or Instant Scratch-Its prize, complete the following steps: 1. (EXAMPLE: If there are 10 in . If you bought a ticket for a New York Lottery game but reside overseas, you can also claim prizes by mail. 1Lakh may be claimed from the District Lottery Offices concerned. Players can walk-in at their convenience and be assisted on a first-come basis. WINNING TICKET CLAIM FORM If you are a U.S. Resident: By signing below, I am stating, under penalties of perjury, that I am the lawful owner of the ticket(s)/voucher(s) identified California State Lottery (Lottery) from processing your prize claim. Print and fill out the CLAIM FORM if your prize is $600 or more. Georgia Lottery Corporation P.O. Instructions to Claimant: Please print legibly in black or blue ink. Mail this signed Million Dollar Replay O˜cial Prize Claim form to: NJL - MDR PO Box 018 Trenton, NJ 08625-0018 Must be 18 or older to buy a lottery ticket. However, for prizes over $600 you may need to complete a Claim Form and send, or take, it along with your prize winning ticket along to one of the States' claim centers or Lottery District Office. Prizes up to and including $50,000 can be claimed by mail. GLC kiosks at the Hartsfield-Jackson Atlanta International Airport are open Monday through Friday from 8:30 a.m. to 7:30 p.m. for prize claims up to $25,000. Lottery Win Claim Forms In most States you can claim lottery prizes of up to $600 at participating retailers. For Prizes $600+ 1. PRIZE CLAIM NORTH DAKOTA OFFICE OF ATTORNEY GENERAL LOTTERY DIVISION SFN 59415 (08-2021) INSTRUCTIONS. Box 548810, OK 73154-8810 unable to check it for prizes. Mail this form and ticket(s) (certified mail recommended) to: Prize Claims, Nebraska Lottery, P.O. We know you're eager to claim your prize, but any missing or incorrect information will cause a delay in receiving your winnings. Complete items 1-11 and sign bottom of form. Get the Lottery Prize Claim Declaration Form you need. If the prize has not been paid in 12 months from the last draw on the ticket, you will also need to submit the completed Ex Gratia Statutory Declaration Form . 17. We already mentioned that small prizes are sent to your online account or claimed at a local seller. Mail to: Minnesota State Lottery P.O. If you have any questions on mailing your claim, email the Illinois Lottery Claims Department at LOT.Claims@illinois.gov. $599 and Under Claim Process Once the e-claim process is completed and winning tickets are validated, a check will be mailed to players within approximately three to four weeks. §§18C-120(b)(1) and 18C-132(l)). If your prize is $601 or above, you will need to fill out the entire Claim Form (including your Social Security Number, TIN or FEIN), a current and valid government-issued ID, and your winning ticket. Processing time, once claim is received and verified, is approximately 8 weeks. Box 93190. If prize(s) are $601 or over, provide a copy of your Social Security number and complete line . 1. For Video Lottery prizes, only the 8% state tax withheld. • The Player information requested on this form will be used to validate and process your claim in accordance with the North Carolina State Lottery Act and the regulations adopted thereunder (N.C.G.S. 3) Proof of positive identification is required for all claims of more than $600.00; Photo ID & Proof If you play online via your Players Club Account and win a prize greater than $600, you can claim these prizes at our Georgia Lottery District Offices. Get the Georgia Lottery Claim Form you need. Prizes are subject to federal tax withholding at the time of payment. Prizes up to $600 may be claimed at any Kentucky Lottery retailer. ); 11 VAC 5-11-10, et seq. PA LOTTERY IS NOT RESPONSIBLE FOR LOST OR STOLEN TICKETS OR CLAIM FORMS. Complete all items on this form. Same person fills out claim form and attaches a list of co-owners to the claim form, including the name, address and Social Security Number of each co-owner. Box 131000 Roseville, MN 55113 1.) ); 11 VAC 5-11-10, et seq. 4. o one of our ets and o: Y COMMISSION.O. Click on Done after double-examining everything. Please play responsibly. You also have the option to mail your completed Colorado Lottery Prize Claim Form and signed winning ticket to Colorado Lottery, PO BOX 7, Pueblo, CO . • staple ticket to top copy. Download Winner Claim Form (available in English or Spanish) or pick up a Winner Claim Form at the Phoenix or Tucson Arizona Lottery office. The New Jersey Lottery does recommend you retain the actual ticket(s) that made up your winning entry in the event further validation of your entry required. A. In-person - Bring your signed winning ticket to the Lottery office in Augusta, Maine to claim your prize. The first thing to confirm is that you even need a claim form. Include ticket(s) with claim form and a copy of driver's license or state ID. Name on claim form must match name on the back of the ticket. 4. The CONTACT person should sign and complete the New Jersey Lottery Claim Form . Therefore, U.S. Citizens and Resident Aliens are required to provide a Social Security/Tax ID Number to claim prizes of $25 or more and require a claim form for processing. Gaming Commission, Division of Lottery P.O. 1. Add the date and place your e-signature. Or use the online Claim Form. OKLAHOMA LOTTERY WINNER CLAIM FORM (Individual Winner) - Claim Form 1 OKLAHOMA LOTTERY COMMISSION (OLC) INSTRUCTIONS This form must be completed in order to claim prizes of more than $600 or as required by the Executive Director.. e than $600. A substitute 5754 form is available at www.michiganlottery.com; click how to claim prizes. There are several ways to obtain one of these forms: Visit any Florida Lottery district office and ask for a Claim Form. Your claim will be processed on site unless your prize is a Jackpot win, a Mega Millions prize over $500,000 or a Powerball prize $50,000 and over. Lottery prize amounts of $600 or greater are reported to the Internal Revenue Service. 2. orm. Mail the above in a single envelope to: Louisiana Lottery Corporation Attn: Prize Validations P.O. You can claim your prize by mail: Fill out a claim form, available at your local lottery retailer. Retain a copy of this form and ticket if you are mailing your claim form. Simply click Done after double-examining all the data. For Gaming Site Use Only. Claiming other division lottery prizes Lower divisional prizes are available the first business day following the draw. WD18 9TT. Mail in Claim Form Instructions - prizes $600 and up: Sign and print your name on the back of the ticket. 5. Albuquerque, NM 87199-3190. 2.) Complete and sign the back of the ticket. If you win, you'll know the ticket is safe and you can claim the prize. 100 louisville, ky 40287-0001 winner claim form instructions to claimant • only ticket owners may claim prize! ), as well as the Virginia Debt Setoff Collection Act (Va. Code § 58.1-520, et If you won playing online, prizes up to $600 will be directly deposited into your online account. Present the signed ticket and signed claim form within 180 days of the draw date to the North Dakota Lottery's office: identifies me as the recipient of the prize claimed, that the ticket attached to this form has not been falsely made, altered, forged or counterfeited and all information set out above is correct. We collect certain personal information such as your name, contact information, valid Government Office Hours are 9:00 a.m. to 5:00 p.m., Monday through Friday. Prize winning tickets above Rs.1 Lakh shall be surrendered before the Director of State Lotteries after affixing the . California Lottery, 730 North 10th Street, Sacramento, CA 95811-0336 PRIZE PAYMENT INFORMATION Claims submitted to Lottery Headquarters for processing are paid by check from the California State Controller's Office. To claim a prize by mail you are required to complete a Ticket Receipt Form for individual winnings of greater than $600 or a Substitute 5754 form for club winnings. Date of Birth MM 5. Prizes of any value can also be claimed by mailing the winning ticket to the New York Lottery's headquarters at the address below. 3. 2. The Hoosier Lottery is required by federal law to obtain the prize winner's social security number for all prizes $600 or greater in order to report taxes and to comply with IC 4-30-11-11. We recommend keeping a copy of the front and back of your ticket for your records and that you use registered mail. (This form is only required for claims over £5,000) The claiming and payment of prizes are subject to the rules of the game to which this claim relates: a copy is available for inspection Please remember that postal claims are made entirely at your own risk. Box 131000, Roseville, MN and process a prize claim without the number due to the application of the Virginia Lottery Law and the regulations adopted thereunder (Va. Code § 58.1-4000 et seq. New Mexico Lottery. Box 90010 Baton Rouge, LA 70879-0010 CLAIM FORM INSTRUCTIONS Prizes may be claimed at any of the North Carolina Education Lottery Offices listed below. I CERTIFY THAT I AM . Claim prizes up to $25,000 (limit of 5 claims per appointment) 1. . At the time you receive your prize, the Lottery will provide you with your W2G tax forms. Box 56966 Atlanta, GA 30343 For more information, visit our website at www.galottery.com Pursuant to the Georgia Open Records Act, a prize winner's name, city, county, and state of residence and the amount of the prize won shall be regarded as matters of public record. Claims submitted to Lottery Headquarters for processing are paid by check and mailed from the California State Controller's Office. 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. Prizes up to $99,999.99 may be paid by visiting the Mississippi Lottery Corporation office or by mail by submitting the original ticket, the original Winner Claim Form, and a photocopy of two acceptable forms of identification to: Mississippi Lottery Corporation, Claims Processing, 1800 River Oaks Drive, Suite B-100, Flowood, MS 39232. Yes No ACCEPTABLE FORMS OF PHOTO IDENTIFICATION PLEASE COMPLETE PAGE 2 WINNER CLAIM FORM Mail to: N.Y.S. Visit any Florida Lottery district office and ask for a Claim Form. Prizes can also be claimed in person at Lottery headquarters: 1199 Shoreline Lane, Suite 100, Boise, ID 83702. CLAIMS A LOTTERY PRIZE BY MEANS OF FRAUD, DECEIT OR MISREPRESENTATION IS GUILTY OF A FELONY PUNISHABLE BY A FINE AND OR IMPRISONMENT. The Texas Lottery Commission must check claims over a certain amount for state warrant holds and IRS reporting. Open it using the cloud-based editor and start altering. Instructions to redeem your winning ticket by mail: Sign your name and write your address on the back of your ticket. Prize Claim. SA Lotteries Prize Claim Form for lottery and Instant Scratch-Its tickets purchased in South Australia. First Name 3. Open it up with online editor and start adjusting. Residency. You should make a copy of the front and back of the signed ticket and the completed claim form for your records. All prize claim documentation must include the claimant's legal first and last name as shown on the valid government issued identification that will be presented with the claim documentation. Complete the Louisiana Lottery Prize Claim Form and be sure it includes your telephone number and mailing address for your prize check; Photocopy your valid driver's license or current picture identification. W2G. PLEASE USE THIS FORM FOR PRIZE CLAIMS OF $600 OR MORE AND QUESTIONABLE TICKETS RETAILER INSTRUCTIONS Instruct Claimant to sign back of ticket. Find more information and safety requirements here. ID Type (do not record ID number) Gaming Site Location Gaming Site Contact Gaming Site Phone Number. White Copy - Georgia Lottery Canary Copy - Claimant Copy INSTRUCTIONS TO FILE YOUR WINNER CLAIM FORM: 1 through 5 below. Disclosure of social security number is required for prizes above $500 and is used for withholding of federal and state income tax. SSN# / FIN# 10. • To receive winnings by mail, send original ticket(s) and claim form in an envelope addressed to: Prizes, PO Box 777, Madison, WI 53774 • Winning lotto tickets $50,000 or more, or tickets 90 days past the draw date, may take several hours to process. Winner claim forms cannot be processed without this information. Lottery District Offices are open Monday through Friday 8AM to 5PM to accept claim forms. of $100,000 or more Claims must be presented at Lottery Headquarters. Box 95145, Lincoln, NE 68509-5145 Zip Code 9. Winner Claim Form. Do not cut, staple or damage your ticket in any way. Are you related to someone who owns or works at a lottery retailer/sales agent? Or by contacting any one of Lottery's claim centers or Public Relations department at 517-373-1237. of claim to change payment option from Annuity to Cash. Sign the back of your ticket. Mailing Address[Street, Route or PO Box#]6. Download Claim Form A player may also download and print a Prize Claim Form (PDF) or pick up a form from a lottery retailer, complete and sign the form, and send it along with the signed winning ticket to: North Dakota Lottery PO Box 204 Bismarck, ND 58502-0204 Please send a copy of your ID along with the Prize Claim Form and winning ticket. Tatts NT Prize Claim Form for lottery tickets purchased in the Northern Territory. You may claim at a Colorado Lottery Claim Center in person by appointment or if your claim is $5,000 or less, you can process your claim online using a secured link that will be provided to you. Complete and sign the back of the ticket(s). You do not need a claim form. All claimed prizes of greater than $600 will receive a W-2G at time of prize payment. If a winner is a non-resident alien, the Lottery is required to withhold 30% federal withholding tax from all prize payments. TO CLAIM A PRIZE BY MAIL . Lottery Prize Claim Declaration Form (Single and Group) For Prizes of $1,000 or more. KEEP A COPY OF THIS FORM AND A COPY OF THE F RONT AND B ACK OF THE TICKET. Prizes of $1 to $5,000,000 may also be claimed by mail. Fill in the blank areas; concerned parties names, addresses and numbers etc. STANDARD CLAIM FORMFOR RETAILER/CLAIM CENTER USE Mail to:CLAIMS DEPARTMENT PENNSYLVANIA LOTTERY PO BOX 8671 HARRISBURG PA 17105-8671 FILING STATUS CLAIMANT'S NAME (LAST NAME FIRST, FOLLOWED BY FIRST NAME AND INITIAL) ADDRESS CITY STATE ZIP CODE Winners of $600 or more must also complete a claim form. (This form is only required for claims over £5,000) The claiming and payment of prizes are subject to the rules of the game to which this claim relates: a copy is available for inspection Please remember that postal claims are made entirely at your own risk. Request a Claim Form To submit this form, Javascript must be turned on. You'll need to send the winning ticket, plus a completed Prize Claim Form for prizes over £5,000, to: The National Lottery. Michigan Lottery prizes up to and including $99,999.99 can be claimed by mail. Customize the template with smart fillable areas. The e-claim option applies to winning tickets up to $10,000. Last Name2. PO Box 287. Sign and date this form. Winner Claim Form . do not staple through any number or play area on ticket. Residency. For prizes of $1,500 and more, Oregon state tax . For prizes of $600 and below, you will need to complete a Ticket Receipt Form or send a written . If the prize is over $600, fill out a Claim Form to submit with your ticket. At the time you receive your prize, the Lottery will provide you with your W2G tax forms. • you must sign your name on the claim form. If you won over $1 million please call the Illinois Lottery Claims Department at (217)-524-5147 immediately! If yes: Employer: Powerball/Mega Millions: Player has 60 days after becoming entitled to a prize to elect a payment option. Please Separate the Lottery copy from your receipt copy. Complete Boxes 1, 2 and 3. Winners sharing a prize must contact the nearest Ohio Lottery regional office. Substitute Form W-9 . For prizes above $600, you will receive an email with instructions on how to process your claim and collect your winnings. Our mailing address is: Pennsylvania Lottery ATTN: CLAIMS 1200 Fulling Mill Road, Suite 1 Middletown, PA 17057 You do not have to live in Pennsylvania to play a game or win a prize, but the Pennsylvania Lottery can only pay prizes on winning tickets that it has sold. • complete items 1 through 10 below. The group should assign one person to serve as the contact. 4. Lottery Prize Claim Declaration Form (Group) Lottery Prize Claim Declaration Form (Group) For Prizes of $1,000 or more RESET For Prize Centre purposes only Customer reference number ID type (do not record the ID number) Date of claim (yyyy/mm/dd) Claimant Information Legal Name (as shown on government issued ID): First name Middle name Home address - Street number, street name, unit/apt . Postal claims must be received by the National Lottery before the 180-day claim period expires. If you're claiming a prize valued at $600 or more, you will need to complete a Florida Lottery Claim Form either in your name or the desired entity's name.
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