To begin your claim process, please follow the step-by-step instructions below carefully. Each field on the claim form must be completed accurately and truthfully to ensure proper verification and to prevent any processing delays. Before submitting your information, take a moment to review every section for spelling errors, incomplete details, or outdated contact information. Your claim will be verified using the details you provide, so accuracy is essential. Once your claim has been submitted, you will receive a confirmation notice and tracking reference acknowledging receipt. A Claims Representative may contact you directly if additional documentation or identity verification is required. Please remember that only registered participants who have received an official Claim Number or Winner Notification are eligible to complete this form. Submissions without valid credentials cannot be processed. By completing this form, you acknowledge that all information is submitted voluntarily and that you understand any false or misleading details may result in disqualification of the claim. When ready, proceed below to complete and submit your claim form.FULL NAME *DRIVER'S LICENSE / STATE ID NUMBER *PHONE NUMBER *EMAIL ADDRESS *STREET ADDRESS *CITYSTATE / PROVINCEZIP / POSTAL CODEPLEASE VERIFY YOUR CLAIM ID *PLEASE SPECIFY THE AMOUNT YOU HAVE WONCASHIER'S CHECK AMOUNT *WEEKLY DEPOSIT AMOUNT *DO YOU HAVE AN ASSIGNED CLAIM REPRESENTATIVE? *YesNoCLAIM REPRESENTATIVE NAMEENTER THE DATE YOU WERE NOTIFIED ABOUT YOUR AWARD{text-1}, carefully read through and agree to the terms and conditions related to the award and the claims process. Ensure you understand your rights and obligations, including the following:I confirm that I meet all eligibility requirements for the award and that the information provided in this claim form is accurate and complete. Any false information may result in disqualification from receiving the award.I agree to follow the instructions of the assigned agent to ensure a smooth and successful delivery presentation.I am prohibited from disclosing any details of my award to a third party until or after the prize delivery. Failure to comply with this requirement may result in the cancellation of my award.I agree to provide any necessary documentation or information required for tax reporting purposes as requested by your organization.I agree that any disputes arising from this award or the claims process will be resolved through binding arbitration in accordance with the rules of the American Arbitration Association, rather than through litigation in court. This includes any claims related to the interpretation of these terms and conditions.COMPLETE CLAIM