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Prize Claim Form

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Prize Claim Form Prize Congratulations When can I claim Claim you’re a winner! my prize? Form This form is required by all players claiming a Golden Claiming major lottery prizes Casket prize that cannot be paid in-store, including (Division 1, Lucky Lotteries Jackpot Prize Instant Scratch-Its prizes on tickets purchased in or Lucky Lotteries 1st Prize) Tasmania and the Northern Territory. Otherwise, prizes can only be claimed within the State in which the entry Major lottery prizes are available for payment from was originally purchased. the first business day two weeks following the draw. Prizes less than $1,500 may be claimed in-store. Claiming other division lottery prizes To claim your lottery or Instant Scratch-Its prize, complete the Lower divisional prizes are available for payment from the first business day following the draw. following steps: Claiming prizes after more than 7 years 1. Complete the Prize Claim Form. � Section 1: Fill in your personal details. Your entitlement to claim a prize ends 7 years after Congrats on � Section 2: Fill in your bank details and sign the the date of the lottery draw. This time frame is Claimant Declaration. prescribed at law in Queensland. If it has been more than 7 years since the relevant draw, we will not your win! � Section 3: Provide details of lottery or Instant check your ticket for prizes. Here’s how to Scratch-Its ticket/s. � Take a photocopy of the Prize Claim Form for your claim your prize. records. For more information or enquiries please contact us 2. Sign ORIGINAL winning lottery or Instant Scratch-Its ticket/s. Address Shop 1, 180 Ann Street, � Write your name, address and signature on the Brisbane QLD 4000 back of the ORIGINAL winning lottery or Instant Scratch-Its ticket/s. Office Opening Hours 8:30am – 5pm, Monday to Friday � Take a photocopy of your winning ticket/s for your own records. Phone 131 868 during business hours Phone Business 8am – 5pm (AEST), 3. Submit Prize Claim Form in person or by post. Hours Monday to Sunday � In person – Shop 1, 180 Ann Street, Brisbane QLD 4000. Email [email protected] � By post – We recommend using Registered Post for added security. Mail Prize Claim Form and original winning ticket/s to: This Prize Claim Form is provided by Golden Casket Lottery Corporation Limited ABN Administration 27 078 785 449, as the licensed lottery operator in Queensland. It is current at the Locked Bag 1 date listed below and is subject to the Lotteries Rule available at thelott.com. The “Golden Casket” name and logo are registered trade marks used by Golden Casket Spring Hill, QLD 4004 Lottery Corporation Limited ABN 27 078 785 449 under licence. July 2021 Official Home of Australia’s Lotteries Please photocopy this form and your winning lottery or Instant Prize Claim Form Scratch-Its ticket/s for your personal records before sending Complete sections 1, 2 and 3 below and mail to the original ticket/s and form ADMINISTRATION, Locked Bag 1, Spring Hill, Qld, 4004. to us. 1. Claimant Details (please print clearly) Important notice Legal Name/s in full Date of Birth Payment made pursuant to the / / claim, if any, will be made by bank transfer to the name and Address bank account of the claimant shown. Please contact us to enquire about any additional payment directives relating to Postcode multiple claimants. If the claim is rejected the claimant will be notified. Daytime Phone No. Email Address For all enquiries please phone our Contact Centre on 131 868. Members Club card (previously Winners Circle) number (if applicable) NOTE: Outlet Owners or staff of an Outlet MUST refer to Retailers Web for information on claiming a prize. 2. Prize Claim Form Declaration – Claimant’s Declaration (please print clearly) In the event an electronic funds transfer is rejected, we will use the information on this form to make reasonable attempts to contact you to confirm your banking details. Where we cannot make contact with you, a cheque may be issued in lieu or we will treat the funds in accordance with unclaimed money laws. Please provide your bank details for direct deposit of your prize payment: Financial Institution Name Account Name Branch Address Branch (BSB) No. Account No. NOTE: Any changes or alterations — including whiteout to bank details must be initialled by the claimant. I hereby claim payment for any prizes associated with the attached lottery ticket/s and/or Instant Scratch-Its ticket/s and I declare that • To the best of my knowledge and belief all of the I understand that: information in this claim is true and correct; • it is an offence under the Lotteries Act 1997 to alter or forge a lottery ticket or • I am over the age of 18 years; Instant Scratch-Its ticket or obtain a benefit as a result of a dishonest act. • I am the rightful owner of the attached lottery • any signature/s on the back of ticket/s should match the signature/s on this Prize Claim Form or Instant Scratch-Its ticket/s; and Claimant Signature/s Date • I confirm that I am not an owner or staff member of a Golden Casket Outlet. NOTE: If there are two names on the membership card then both members are required to sign the declaration. 3. Lottery Ticket / Instant Scratch-Its Ticket Details (please print clearly) Please include with this Prize Claim Form all ORIGINAL lottery tickets or Instant Scratch-Its tickets as listed below in an envelope. It is important you include your name, address and signature on the back of ALL tickets. Processing may take up to 10 working days from when we receive this form. Mail to ADMINISTRATION, Locked Bag 1, SPRING HILL QLD 4004. Registered Post is recommended. In accordance with the Lotteries Act 1997, Section 129 (2) (b), our results and prize history only allows a prize claim period of seven years from the date of the draw. Any claim for a prize that is outside the seven year claim period subsequently cannot be paid. Send completed Prize Claim Form to Golden Casket. Include ONLY ORIGINAL lottery ticket/s / Instant Scratch-Its ticket/s. ticket/s. Scratch-Its lottery / Instant ORIGINAL ticket/s ONLY Include Casket. Golden Form Prize Claim to Send completed Draw No. Game (see below)* (Lottery games only) Lottery Ticket Number or Instant Scratch-Its Ticket Validation Barcode Number Prize Amount (if known) Total $ *Game: SGL – Saturday Gold Lotto MWGL – Monday & Wednesday Gold Lotto SJP – Lucky Lotteries Super Jackpot SPL – The Pools ISI – Instant Scratch-Its OZ – Oz Lotto PBL – Powerball MJP – Lucky Lotteries Mega Jackpot S66 – Super 66 SFL – Set for Life Collection of personal information We are collecting your personal information in this form for the purposes of registering, verifying and/or paying a prize and for the purposes of providing you with our products and services. We will also use your personal information to send you marketing and promotional material about lotteries and our community partners (unless you ask us not to). If we cannot collect your personal information, we will not be able to process your prize claim. The collection of this information is permitted under the game rules. The personal information we collect may be disclosed to other entities in the Tabcorp Holdings Ltd group, a third party as required by law and to third parties who assist us in running our business. Some of these third party service providers may be located offshore. For more information about these offshore disclosures, our handling practices and details July 2021 about how you may access and seek correction of your personal information or make a complaint please refer to our Privacy Policy located at https://www.tabcorp.com.au/privacy. Date Claim/ Received / No. of Lottery Tickets Received No. of Instant Scratch-Its Received Other Claim ID Number Claim Received By Signature Claim Verified By Signature Claim Entered By Processed By Date Processed/ / Payment Details Amount 1st Authoriser 2nd Authoriser Date Authorised / / Office use only.
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