Professional Documents
Culture Documents
Claim Form SK
Claim Form SK
Claim Form SK
(
GOVERNMENT OF SIKKIM ONLINE LOTTERY - WINNER CLAIM FORM
(Please read instructions overleaf)
PLEASE FILL IN WITH CAPITAL LETTERS your name, address and phone number on the back
your ticket- YOU MUST SIGN YOUR TICKET. Any winning Numbers-game ticket of upto
Rs. 10,000/- can be claimed at any licensed numbers-game lottery retailer, regardless of where the
ticket was purchased, provided their cash balances are adequate.
RETAIN A PHOTOCOPY of the front and back of your winning ticket and of this completed form
for your personal records. Staple the ticket to the top right corner of this form and read
instructions overleaf for getting your prize amount.
___________________
1. FIRST NAME
___________________
2. MIDDLE NAME
__________________
3. SURNAME
Date ________________
INSTRUCTIONS
1. Put your name, address and signature on back of the ticket.
2. The winning ticket and claim form must be completed in the name of one individual
or legal entity.
3. Complete the claim form and follow the instructions provided.
4. Indicate the prize amount legibly.
5. You are required t o approach any retailer appointed by PAN India Network Ltd
(Playwin) and get your ticket validated.
6. Prize amount not exceeding Rupees Ten Thousand (Rs.10, 000) shall be paid by the
Retailer.
7. Prize amount above Rupees Ten Thousand (Rs.10, 000/- shall be paid directly by the
Director - Sikkim State Lotteries. The prize amount shall be claimed by submitting a
claim form along wit h 3 passport size photographs duly at tested and supported by an
affidavit sworn in before a first class magistrate in person or through any
scheduled/nationalized bank. The claim ma y be sent to Director, Sikkim State
Lotteries, Gangtok 737101 by registered/ insured post at claimants own risk.
Payment will be made after verification regarding genuineness of the ticket to the
claimant of the ticket, by demand draft/cherub after deducting the tax as applicable
On the date.
8. Prizes will be given only on complete physical verification of the document s, ticket
And proof of identity to the absolute discretion of Government of Sikkim. Decision of
Government of Sikkim shall be final and binding on t he Claimant.
9. Incomplete forms shall be considered invalid.
10. For any assistance required, you may contact any Playwin office.
11. Government of Sikkim/ Playwin is not responsible for any non-delivery of mails, lost
in transit or non-receipt of forms dispatched by the Claimant.
12. Persons/ entities disqualified by law are not eligible to the prize money.
13. Claimant will be responsible to resolve any dispute regarding the claim on prize
money and Government of Sikkim/Playwin shall not bear any responsibility for the
same.
14. The processing of documents received from the Claimant will be done within 90
working days from the receipt thereof.
15. The prize amount will be paid directly by the government of Sikkim and sent t o the
address in the claim form. Such payment will be subject to Tax deduction at source.
16. Playwin is entitled t o use the winner's name, photograph and other information for
promotional and publicity purposes and t he Claimant agrees to the same without any
further claim for payment.
17. Claimant shall not indulge in any press and/or media interviews without the prior
permission from Playwin.
18. Any dispute regarding the payment of prize shall be subject to the exclusive
jurisdiction of the Courts in Gangtok only.
19. Prize should be claimed within 90 days from its declaration.
20. Government of Sikkim or Playwin may advise you to submit more information over
and above mentioned in the claim form.
PAN India Network Ltd:
Mumbai: 135, Continental Building, Dr. A. B. Road, Worli, Mumbai - 400 018,India, Tel: 022-24815671
Kolkata: Flat No. 11,Harrington Mansion,8, Ho Chi Minh Sarani,Kolkata- 700071, Tel:033-22822660/61