How to Fill Out a Claim Form 

CONGRATULATIONS ON YOUR WIN!
NOW-STEP BY STEP-WE’RE GOING TO SHOW YOU HOW TO FILL OUT YOUR CLAIM FORM.
REMEMBER, IF YOU DON’T FILL OUT THIS FORM CORRECTLY, YOUR PRIZE PAYMENT CHECK WILL BE DELAYED.
SO….LET’S BEGIN!:
FIRST, DOWNLOAD A CLAIM FORM FROM THE CALIFORNIA LOTTERY WEBSITE AT CA LOTTERY.COM
IF YOU CAN, COMPLETE THE ENGLISH FORM ONLINE BECAUSE TYPED DOCUMENTS ARE EASIER TO READ. *ILLEGIBLE FORMS ARE A COMMON MISTAKE THAT DELAY PRIZE PAYMENTS!*
LET’S START WITH THE CLAIMANT INFORMATION SECTION:
YOU MUST ENTER YOUR FULL LEGAL NAME. THIS IS IMPORTANT: YOUR LAST NAME GOES FIRST, YOUR FIRST NAME GOES IN THE BOX BELOW. TO THE RIGHT, ENTER YOUR MIDDLE INITIAL HERE.
*PEOPLE PUTTING THEIR FIRST NAME IN THE LAST NAME BOX IS A COMMON MISTAKE!*
YOUR LEGAL NAME THAT YOU ENTER ON YOUR CLAIM FORM MUST MATCH THE NAME PRINTED ON THE WINNING TICKET.
NEXT…YOU NEED TO ENTER YOUR FULL ADDRESS, AS RECOGNIZED BY THE U.S. POSTAL SERVICE, INCLUDING ANY APARTMENT OR SUITE NUMBER. DON’T FORGET CITY, STATE AND ZIP CODE.
ENTER YOUR PHONE NUMBER, INCLUDING AREA CODE HERE, AND YOUR EMAIL ADDRESS HERE.
AT THE TOP RIGHT OF THE FORM, ENTER YOUR BIRTH DATE. MONTH GOES FIRST, FOLLOWED BY DAY, THEN YEAR LIKE THIS. **LEAVING THESE FIELDS BLANK IS COMMON MISTAKE **
RIGHT BELOW, ENTER YOUR SOCIAL SECURITY NUMBER OR TAXPAYER IDENTIFICATION NUMBER. THIS INFORMATION IS NOT REQUIRED.
FOR WINNERS WHO ARE NOT U.S. CITIZENS AND WHO ARE NOT RESIDENT ALIENS, NO PROBLEM, YOU CAN STILL CLAIM YOUR PRIZE! LEAVE THE SSN/TIN FIELD BLANK … AND INSTEAD, CHECK BOTH BOXES DOWN BELOW FOR “I DO NOT HAVE A SOCIAL SECURITY NUMBER” AS WELL AS “I AM NOT A U.S. CITIZEN AND I AM NOT A RESIDENT ALIEN.”
FINALLY THERE ARE THREE RETAILER QUESTION BOXES AT THE BOTTOM OF THE PLAYER INFORMATION SECTION THAT YOU ARE REQUIRED TO CHECK IF APPLICABLE.
*NOT ANSWERING THESE QUESTIONS IS A COMMON MISTAKE THAT DELAY PRIZE PAYMENTS!*
NEXT IN THE TICKET INFORMATION SECTION, ENTER THE 15-DIGIT TICKET NUMBER FOR SCRATCHERS. LEAVING THE LAST THREE BOXES BLANK. ALSO, ENTER THE AMOUNT OF THE PRIZE YOU ARE CLAIMING HERE.
BE SURE TO FILL OUT THE INFORMATION ON THE BACK OF YOUR TICKET AND ENSURE THAT THIS MATCHES THE INFORMATION ON YOUR CLAIM FORM. SIGN THE BACK OF THE TICKET AND MAKE A COPY OF BOTH SIDES OF THE TICKET.
FINALLY, SIGN AND DATE YOUR CLAIM FORM HERE AND HERE.
REMEMBER, THIS SIGNATURE MUST MATCH THE SIGNATURE ON YOUR WINNING TICKET.
*NOT SIGNING THE CLAIM FORM IS THE MOST COMMON MISTAKE SO DON’T FORGET BECAUSE THIS WILL DELAY YOUR PRIZE PAYMENT!*
NOW MAKE A COPY OF YOUR COMPLETED CLAIM FORM….THEN STAPLE YOUR TICKET TO THE FRONT OF YOUR CLAIM FORM HERE IN THE TICKET INFORMATION SECTION. MAKE SURE THE NAME AND ADDRESS FIELDS ON THE TOP OF THE FORM ARE VISIBLE.
IN THE DEMOGRAPHIC INFORMATION SECTION (THESE ARE THE GREY FIELDS LOCATED ON THE THIRD AND FINAL PAGE OF THE CLAIM FORM) -- THERE ARE A SERIES OF QUESTIONS THAT WE ENCOURAGE YOU TO ANSWER, BUT THIS IS NOT MANDATORY.
AND YOU’RE DONE!
WE KNOW YOU’RE EXCITED WHEN YOU WIN. BUT IT’S IMPORTANT TO SLOW DOWN, READ THE CLAIM FORM INSTRUCTIONS CAREFULLY AND FILL OUT ALL THE REQUIRED FIELDS CORRECTLY.
ALSO, RETAIN COPIES OF THE TICKET AND THE COMPLETED CLAIM FORM.
REMEMBER….IF YOU SUBMIT A CLAIM FORM WITH MISTAKES, YOUR PRIZE PAYMENT WILL BE DELAYED!
AGAIN, CONGRATULATIONS AND THANKS FOR PLAYING!

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