Congratulations on your recent win!
Due to the amount being $600 or more, we will need your SSN# before we can process your prize money. By law, we are required to provide a 1099 form at the end of the year for everyone winning/accumulating at least $600 (net) from us for the year.
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Email *
Winner's Name
Pay to Name (if different from winner's name)
Payments by check will have both the winner's and payee's names on the check.
SSN # of Payee
Rest assured that your number is kept confidential.
Payment Method
Pay To Details *
This can be your mailing address (for check payment), email address or phone number depending on your selected payment method.
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