PRIZE CLAIM FORM - PRIVATE & CONFIDENTIAL

PLEASE USE THIS FORM FOR ALL CLAIMS OVER £5000 OR FOR CLAIMS
MADE AT NATIONAL LOTTERY REGIONAL CENTRES
Please see overleaf for details
COMPLETE IN CAPITAL LETTERS
Claimant's Full Name _____________________________________________ Telephone Numbers
(As shown on presented identification, eg Driving Licence, Passport)

Address ________________________________________________________ Home ___________________________

_______________________________________________________________ Work ___________________________
County________________________________
Postcode _____________________ Mobile __________________________
I declare that:
* The above information is true and complete
* I am aged 16 or over
* The account details below will accept the transaction (where receiving payment by CHAPS)
* Subject to this claim in respect of the attached ticket/ticket details being accepted under the rules of the National Lottery game to which this
claim relates, I am legally entitled to the prize claimed and I agree to pay Camelot UK Lotteries Limited and the promoter of the game, if
different, any costs, losses, damages and expenses they may suffer as a result of any misrepresentation
* By signing this form, you confirm you have read the Privacy Notice overleaf

Claimant's signature ______________________________________________ Date ____________________________

Witness' Name __________________________________________________ Witness' Signature

Address ________________________________________________________
_______________________________________________________________ ________________________________
County________________________________
Postcode _____________________
RETAILER PUBLICITY AGREEMENT
I consent to the retailer which sold me my winning ticket to be notified of the game and prize level won for promotional purposes.
This information will not be released until 3 months has passed from receiving my prize.
Please note: This form does NOT authorise Camelot UK Lotteries to release your name and address for any purpose.

Winner's Name __________________________________ Winner's Signature ____________________________________

FOR ADMINISTRATION USE ONLY
IDENTIFICATION PROVIDED Additional Information
Proof of ID ______________________________________________________ _______________________________
Proof of Address _________________________________________________ _______________________________
Proof of Bank ____________________________________________________ _______________________________

Claim ID Number _________________________________________________ Winner ID _______________________

Draw-based Ticket Scratchcard Ticket Interactive/Subscription

Retailer Y N Employed NL Retailer Y N Ticket Damaged Y N
Number/Name of Game ___________________________________________ Comments
Draw Date ______________________________________________________ _____________________________
Ticket Numbers(s) ________________________________________________ _____________________________
Claim Processed by _______________________________________________ _____________________________
Claim Checked by ________________________________________________ _____________________________
Prize Claim Amount £ _____________________________________________ _____________________________
PAYMENT METHOD (CHAPS/CHEQUE)
I instruct Camelot UK Lotteries Limited to set up an I instruct Camelot UK Lotteries Limited to
electronic payment to the details supplied below make a payment
Bank Name Prize Value Amount
_____________________________________________ £ , , .
Account Name Cheque Number
_____________________________________________

Sort Code Bank Representative Name & Signature

Account Number __________________________________ Date ___________
CORE-P-18/F-037 V:9 September 2018
THANK YOU FOR PLAYING THE NATIONAL LOTTERY
CLAIMS AT A NATIONAL LOTTERY ON-LINE POST OFFICE ANY PROBLEMS?
Claims for prizes of up to £50,000 may be made at any National The Player's Guide outlines the services provided to players of
Lottery designated Post Office The National Lottery and can be viewed at National Lottery
retailers: copies can be obtained via the National Lottery Line.
CLAIMS AT A NATIONAL LOTTERY REGIONAL CENTRE A structured system for escalation of a complaint in the unlikely
Claims for prizes of any amount may be made at a National event that you remain dissatisfied, you may refer your complaint
Lottery Regional Centre. Claims for prizes over £50,000 must to the regulator of The National Lottery, the Gambling Commission
be made in person at a National Lottery regional centre or or The National Lottery's alternative dispute resolution provider
other agreed location. We would ask you to contact the as outlined on our website www.national-lottery.co.uk.
National Lottery Line on 0333 234 50 50 first for further
information. NOTES
The claiming and payment of prizes are subject to the rules of the
Identification should be provided for all claims over £500 game to which this claim relates: a copy is available for inspection
from your National Lottery retailer of by calling the National
The following identification is acceptable in combination: Lottery Line on 0333 234 50 50.
Passport - Any nationality is sufficient providing it displays
photograph, name, signature and is current PRIVACY NOTICE
Driving Licence (Provisional or Full) - Any nationality is Camelot UK Lotteries Limited uses the personal and contact
sufficient providing is displays photograph, name, address, information provided by you on this prize claim form, and your
signature and is current financial information, to enable us to administer your prize claim.
Identification Card issued by Government - Providing it displays We may also use the personal and contact information provided
a photograph, name and signature by you on this prize claim form to contact you in relation to any
Northern Ireland Electoral Identity Card - Providing it displays prize paid [and for research purposes]. To learn more about the
photograph, name and signature information we collect, why and how we use it, see our Privacy
Policy at https://www.national-lottery.co.uk/privacy-policy
If the ID presented is not one of those above, a claimant must
provide a combination of not less than two forms of ID which
verify his/her name, address and signature. Each document
presented must contain and verify two of the elements
required, ie name and address or name and signature

PLEASE NOTE:
All documents must be official and printed - handwritten
documents are NOT acceptable.

Proof of age maybe required.

Utility bills or letters on Her Majesty's Service must be dated

within the last three months.

POSTAL CLAIMS
(This form is only required for claims over £5000)

Please remember that postal claims are entirely at your own risk.
You should therefore consider recorded/registered post, although
neither of these is a guarantee of security. Postal claims cannot
be made if the claim exceeds £50,000. If you claim by post, write
your full name and address on the back of the ticket
and send your ticket with this form to the following address:

Player Services
FREEPOST ANG9295
PO Box 287
Watford
WD18 9ZY