HOW TOCLAIM YOUR
PRIZECONGRATULATIONS ON BEING A
SA LOTTERIES WINNER!
PRIZE CLAIM FORM
by
Claiming major lottery prizesMajor lottery prizes including; first division prize, first prize and jackpot prize for Lucky Lotteries and Spot 9 and Spot 10 top prizes for Keno, are available for payment from the first business day two weeks following the draw.
Claiming other division lottery prizesLower divisional prizes are available the first business day following the draw.
Prizes outside 12 month claim periodAny prize won on a ticket that is older than 12 months will have been forfeited to the South Australian Lotteries Commission.
If you are making a claim on an out of date ticket please complete an Ex Gratia Statutory Declaration which can be downloaded from www.thelott.com/salotteries
Tickets outside the 12 month period are not payable under the Lotteries Act, however SA Lotteries have a special discretion to pay, and there are associated administration costs enabling us to process these payments.
PRIZE CLAIM CONDITIONS
For more information or enquiries please contact SA Lotteries
Address �����������������������������188 Richmond Road, Marleston, SA 5033
Office Opening Hours ����8:30am – 4:30pm, Monday to Friday
Phone �������������������������������131 868 during business hours
Phone Business Hours ����8am – 5pm, Monday to Saturday 8am – 2pm, Sunday
Email ���������������������������������� [email protected]
Gamble Responsibly 1800 858 858.
The information in this guide is current at time of printing in March 2020 and this information is subject to the Lotteries (General) Rules available online at thelott.com.
MARCH 2020
This form is required by all winners claiming a prize that cannot be paid at an SA Lotteries Outlet. Some Retailers may pay prizes higher than $500 at their discretion (an Outlet’s payout limit is authorised by SA Lotteries). Prizes over $5,000 are processed at SA Lotteries Head Office upon submission of a Prize Claim Form in person or by post.
CONGRATULATIONS ON BEING A WINNER!
To claim your lottery, Keno or Instant Scratch-Its prize, complete the following steps:1. Complete the Prize Claim Form
F Section 1: Fill in your personal details.
F Section 2: Fill in your bank details.
F Section 3: Sign the Claimant Declaration.
F Section 4: Provide details of lottery, Keno or Instant Scratch-Its ticket/s.
F Take a photocopy of the Prize Claim Form for your records.
2. Sign ORIGINAL winning lottery, Instant Scratch-Its or Keno ticket/s
F Write your name, address and signature on the back of the ORIGINAL winning lottery, Keno or Instant Scratch-Its tickets.
F Take a photocopy of your winning ticket/s for your records.
3. Submit Prize Claim Form in person or by post.
F In person – Visit 188 Richmond Road, Marleston, SA 5033, during office hours.
F By post – SA Lotteries recommends using Registered Post for added security. Mail Prize Claim Form and original winning ticket/s to:
• Administration PO Box 74 Marleston, SA 5033
Gam
e (s
ee b
elo
w)*
Pri
ze A
mo
un
t (if
kn
ow
n)
Lott
ery
or
Ke
no
or
Inst
ant
Sc
ratc
h-I
ts T
ick
et
Nu
mb
er
Ple
ase p
rovi
de y
ou
r b
ank
deta
ils b
elo
w f
or
dire
ct d
ep
osi
t o
f yo
ur
priz
e p
aym
en
t:
Fin
anc
ial
Inst
itu
tio
n N
ame
Bra
nc
h A
dd
ress
Ac
co
un
t N
ame
Bra
nch
(BSB
) No
.A
cco
un
t N
o.
—
2. P
AY
ME
NT
OF
PR
IZE
CL
AIM
(p
leas
e p
rin
t c
lear
ly)
Inac
cu
rate
or
inco
mp
lete
ban
k ac
co
un
t d
eta
ils m
ay le
ad t
o t
he
pay
me
nt
be
ing
de
laye
d o
r re
jec
ted
by
you
r fin
anc
ial in
stitu
tio
n. I
n t
he
eve
nt
that
th
e f
un
ds
tran
sfe
r is
re
jec
ted
, a
ch
eq
ue
may
be
issu
ed
in lie
u.
Co
mp
lete
sec
tio
ns
1, 2
, 3 a
nd
4 b
elo
w a
nd
mai
l to
A
DM
INIS
TR
AT
ION
, PO
BO
X 7
4, M
arle
sto
n, S
A 5
03
3, A
ust
rali
a.1
. CL
AIM
AN
T D
ET
AIL
S (
ple
ase
pri
nt
cle
arly
)
Po
stc
od
e
/
/
Leg
al N
ame
in f
ull
Ad
dre
ss
Dat
e o
f B
irth
Day
tim
e P
ho
ne
No
.E
mai
l A
dd
ress
Send completed Prize Claim Form to SA Lotteries. Include ONLY ORIGINAL lottery / Keno / Instant Scratch-Its ticket/s.
IMP
OR
TA
NT
NO
TIC
EP
aym
en
t m
ade
p
urs
uan
t to
th
e
cla
im,
if a
ny,
will
be
mad
e b
y b
ank
tran
sfe
r to
th
e
nam
e
and
b
ank
acc
ou
nt
of
the
c
laim
ant
sho
wn
. P
leas
e
co
nta
ct
SA
Lo
tte
rie
s to
e
nq
uir
e
abo
ut
any
add
itio
nal
p
aym
en
t d
ire
cti
ves
rela
tin
g
to
mu
ltip
le
cla
iman
ts.
If
the
c
laim
is
re
jec
ted
th
e
cla
iman
t w
ill
be
no
tifie
d.
For
all
en
qu
irie
s p
leas
e p
ho
ne
ou
r C
on
tac
t C
en
tre
on
13
1 8
68
.
Ple
ase
ph
oto
cop
y th
is f
orm
an
d
you
r w
inn
ing
lo
tte
ry,
Ke
no
o
r In
stan
t Sc
ratc
h-I
ts
tick
et/
s fo
r yo
ur
pe
rso
nal
re
cord
s b
efo
re
sen
din
g t
he
ori
gin
al t
icke
t/s
and
fo
rm t
o S
A L
ott
eri
es.
Co
lle
cti
on
of
pe
rso
na
l in
form
ati
on
Th
e p
ers
on
al in
form
atio
n c
olle
cte
d f
rom
yo
u in
th
is d
oc
um
en
t is
so
ug
ht
by
Tatt
s Lo
tte
rie
s SA
Pty
Ltd
AB
N 4
114
624
50
07,
a m
em
be
r o
f th
e T
atts
Gro
up
Lim
ite
d.
Th
e c
olle
cti
on
of
you
r n
ame
an
d a
dd
ress
is r
eq
uir
ed
un
de
r th
e S
A L
ott
eri
es
(Ge
ne
ral)
Ru
les
and
will
be
use
d t
o r
eg
iste
r, v
eri
fy a
nd
pay
yo
ur
pri
ze.
We
may
no
t b
e a
ble
to
pro
ce
ss y
ou
r c
laim
un
less
yo
u p
rovi
de
th
is in
form
atio
n t
o u
s. Y
ou
r in
form
atio
n m
ay b
e d
isc
lose
d t
o t
hir
d p
arti
es
inc
lud
ing
yo
ur
and
ou
r fin
anc
ial in
stit
uti
on
s, o
ur
selli
ng
ou
tle
ts,
ou
r c
on
trac
tors
(su
ch
as
IT p
rovi
de
rs o
r m
ail se
rvic
es)
, o
ur
pro
fess
ion
al a
dvi
sors
, g
amin
g a
nd
oth
er
reg
ula
tors
, le
gal
en
forc
em
en
t ag
en
cie
s o
r as
re
qu
ire
d b
y la
w.
Ou
r P
riva
cy
Po
licy,
ava
ilab
le a
t th
elo
tt.c
om
, co
nta
ins
furt
he
r in
form
atio
n a
bo
ut
ho
w y
ou
may
ac
ce
ss a
nd
se
ek
a c
orr
ec
tio
n o
f yo
ur
pe
rso
nal
info
rmat
ion
, an
d h
ow
yo
u m
ay c
om
pla
in a
bo
ut
pri
vac
y re
late
d m
atte
rs a
nd
h
ow
yo
ur
co
mp
lain
t w
ill b
e d
eal
t w
ith
. F
or
pri
vac
y re
late
d q
ue
rie
s, p
leas
e c
on
tac
t 13
1 8
68
or
pri
vac
y@ta
bc
orp
.co
m.a
u.
Dra
w N
o.
(lott
o &
Ken
o o
nly
)
3. P
RIZ
E C
LA
IM F
OR
M D
EC
LA
RA
TIO
N –
CL
AIM
AN
T’S
DE
CL
AR
AT
ION
Ex
Gra
tia
Cla
ims
• To
th
e b
est
of
my
kno
wle
dg
e a
nd
belie
f al
l o
f th
e i
nfo
rmat
ion
in
th
is
clai
m is
tru
e a
nd
co
rrect
;
• I a
m o
ver
the a
ge o
f 18
year
s; a
nd
• I
am
the
righ
tfu
l o
wn
er
of
the
atta
ched
lo
ttery
, K
en
o
or
Inst
ant
Scra
tch
-Its
tic
ket/
s.
• I c
on
firm
th
at I
am n
ot
an o
wn
er
or
staff
mem
ber
of
a SA
Lo
tterie
s o
utle
t.
• I u
nd
ers
tan
d th
at S
A L
ott
erie
s m
ain
tain
s th
e r
igh
t to
dis
qu
alify
a ti
cket o
r d
ecl
ine to
pay
a p
rize
in t
he c
ase o
f fr
aud
or
as o
therw
ise o
utli
ned
un
der
the S
A L
ott
erie
s (G
en
era
l) R
ule
s.•
An
y si
gn
atu
re/s
on
th
e b
ack
of t
icke
t/s
sho
uld
mat
ch th
e s
ign
atu
re/s
on
th
is p
rize c
laim
form
.
Cla
iman
t S
ign
atu
re
I h
ere
by
cla
im p
aym
en
t fo
r an
y p
rize
s as
soc
iate
d w
ith
th
e a
ttac
he
d l
ott
ery
, Ke
no
or
Inst
ant
Sc
ratc
h-I
ts t
ick
et/
s an
d I
de
cla
re t
hat
:
Ple
ase
incl
ud
e w
ith t
his
Priz
e C
laim
Fo
rm a
ll O
RIG
INA
L lo
tter
y ti
cket
s /
Inst
ant
Scra
tch
-Its
/ K
eno
tic
kets
as
liste
d b
elo
w in
an
en
velo
pe.
It is
imp
ort
ant
you
in
clu
de
you
r n
ame,
ad
dre
ss a
nd
sig
nat
ure
on
th
e b
ack
of A
LL lo
tter
y, K
eno
or
Inst
ant
Scra
tch
-Its
tic
kets
. Pro
cess
ing
may
tak
e u
p t
o 1
0 w
ork
ing
day
s. R
egis
tere
d
Po
st is
rec
om
men
ded
. Mai
l to
AD
MIN
IST
RA
TIO
N, P
O B
OX
74
, Mar
lest
on
SA
50
33,
Au
stra
lia.
An
Ex
Gra
tia C
laim
is a
cla
im f
or
a p
rize
on
a t
icke
t th
at is
ou
t o
f d
ate o
r is
a w
inn
ing
un
reg
iste
red
tic
ket
that
has
been
lost
or
dest
roye
d a
nd
has
been
fo
rfeite
d t
o t
he S
A L
ott
eri
es
Co
mm
issi
on
.
• O
ut
of
Dat
e T
icke
ts –
If
you
are
mak
ing
a c
laim
on
an
ou
t o
f d
ate t
icke
t p
leas
e c
om
ple
te t
his
Priz
e C
laim
Fo
rm a
lon
g w
ith a
n E
x G
ratia
Sta
tuto
ry D
ecl
arat
ion
av
aila
ble
on
th
e S
A L
ott
erie
s w
eb
site
. •
Lost
or
Dest
roye
d T
icke
ts –
If y
ou
are
mak
ing
a c
laim
on
an
un
reg
iste
red
lost
or
dest
roye
d t
icke
t p
leas
e o
nly
use
th
e L
ost
/Dam
aged
Tic
ket
Sear
ch f
orm
ava
ilab
le
on
th
e S
A L
ott
erie
s w
eb
site
.
*Ga
me
:XL
– X L
ott
oO
z –
Oz
Lott
oM
WXL
– M
on
day
& W
edn
esd
ay X
Lo
tto
PB
L –
Po
wer
bal
lKC
T –
Ken
o C
oin
To
ssK
– K
eno
S66
– S
up
er 6
6SP
L –
Th
e P
oo
lsIS
I – In
stan
t Sc
ratc
h-I
tsSF
L –
Set fo
r Li
feSJ
P –
Lu
cky
Lott
erie
s Su
per
Jac
kpo
tM
JP –
Lu
cky
Lott
erie
s M
ega
Jack
po
t
Eas
ipla
y C
lub
Car
d n
um
be
r (i
f ap
plic
able
)
4. L
OT
TE
RY
TIC
KE
T /
IN
ST
AN
T S
CR
AT
CH
-IT
S T
ICK
ET
/ K
EN
O T
ICK
ET
DE
TA
ILS
(ple
ase
pri
nt
cle
arly
)
MARCH 2020
/
/D
ate
Au
tho
rise
dP
aym
en
t D
eta
ils1s
t A
uth
ori
ser
2n
d A
uth
ori
ser
Am
ou
nt
OFFICE USE ONLY
/
/D
ate
Cla
im R
ec
eiv
ed
Cla
im R
ec
eiv
ed
By
Cla
im V
eri
fie
d B
y
No
. of
Lott
ery
Tic
kets
Re
ce
ive
dN
o. o
f In
stan
t Sc
ratc
h-I
ts R
ec
eiv
ed
Oth
er
/
/D
ate
Pro
ce
sse
dC
laim
En
tere
d B
yP
roc
ess
ed
By
Sig
nat
ure
Sig
nat
ure
Cla
im I
D N
um
be
r
NO
TE
: A
ny
ch
ang
es
or
alte
rati
on
s in
clu
din
g w
hit
eo
ut
to b
ank
de
tail
s m
ust
be
init
iall
ed
by
the
cla
iman
t.
PR
IZE
CL
AIM
FO
RM
TO
TA
L$
Dat
e/
/
Dra
w D
ate
(Ken
o &
Ken
o C
oin
To
ss o
nly
)
NO
TE
: Ow
ner
s o
r st
aff m
emb
ers
of
an S
A L
ott
erie
s A
gen
cy M
UST
ref
er t
o
Ret
aile
rs W
eb f
or
info
rmat
ion
on
cla
imin
g a
pri
ze.