Yahoo Lottery Inc Payment Form
PERSONAL INFORMATION
FULL NAME. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AGE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
SEX. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CONTACT ADDRESS. . . . . . . . . . . . . . . . . . . . . . . .
MARITAL STATUS. . . . . . . . . . . . . . . . . . . . . . . . . .
NATIONALITY. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
CURRENT LOCATION. . . . . . . . . . . . . . . . . .
OCCUPATION. . . . . . . . . . . . . . . . . . . . . . . . . . . .
TELEPHONE. . . . . . . . . . . . . . . . . . . . . . . . . . . .
EMAIL. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
ALTERNATE EMAIL. . . . . . . . . . . . . . . . . . . . . . . .
PAYMENT INFORMATION
WE CAN ONLY PAY YOU BY ONLY THREE METHODS,DIPLOMATIC MEANS,CHEQUE DELIVERY TO YOUR ADDRESS,AND BANK TRANSFER.WRITE YES IN THE SPACE IF YOU CHOOSE DIPLOMATIC MEANS,CHEQUE DELIVERY TO YOUR ADDRESS, OR BANK TRANSFER.
IMPORTANT ADVICE: MAKE SURE YOU FILL THIS PAYMENT FORM CORRECTLY AND IF YOU CHOOSE BANK TRANSFER MEDIUM,YOU MUST PROVIDE US WITH YOURBANK ACCOUNT NUMBER, BANK ADDRESS AND BANK NAME FOR EASY TRANSFER.
NOTE:YOU ARE REQUIRED TO KEEP YOUR WINNING NOTIFICATION CONFIDENTIAL UNTIL YOU HAVE RECEIVED YOUR WINNING FUNDS TO AVOID DOUBLE CLAIMING OR ANY CLAIMSISSUE WHICH CAN RESULT TO DISQUALIFICATION.
CHEQUE DELIVERY TO YOURADDRESS. . . . . . . .
DIPLOMATIC MEANS. . . . . . . . . . . . . . . . . . . . . . . . . . .
BANK TRANSFER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BANK ACCOUNT NO. . . . . . . . . . . . . . . . . . . . . . . . . .
BANK ADDRESS/INFORMATION. . . . . . . . . . . . . . . . .
WINNER NUMBER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
AMOUNT WON. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
REFERENCE NUMBER. . . . . . . . . . . . . . . . . . . . . . . . . .
BATCH NUMBER. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
YOU HAVE TO ATTACH ANY OF THE BELOW FOR PROPER IDENTIFICATION.
INTERNATIONAL PASSPORT , DRIVERS LICENSE ,OFFICIAL ID ,NATIONAL ID, OR ANY OTHER ID WHICH IS NOT LISTED HERE FOR IDENTIFICATION.
Regards,
Mr. Adrian Raymond
Telephone: +233542420635
READ THIS IMPORTANT INSTRUCTIONS CAREFULLY:
OUR PAYING BANK WILL ONLY CONTACT YOU IF YOUR PAYMENT FORM IS APPROVED BY THEM BUT,IF IS NOT APPROVED WE SHALL INFORM YOU.
ANY INFORMATION THAT IS PROVIDED BY WINNER MUST BE CORRECT AS PROVISION OF WRONG INFORMATION BY WINNER MAY LEAD TO DISQUALIFICATION OF A WINNER AND YOU ALSO HAVE TO KEEP YOUR WINNING NOTIFICATION CONFIDENTIAL,YOU DON'T HAVE TO TELL ANY ONE ABOUT YOUR WINNING FUNDS($500,000.00)UNTIL YOU HAVE RECEIVED YOUR PRIZE FUNDS($500,000.00) BY YOUR CHOSEN MEDIUM AS TO AVOID DOUBLE CLAIMING OR ANY CLAIMS PROBLEM WHICH CAN RESULT TO DISQUALIFICATION/CANCELLATION OF YOUR PRIZE FUNDS $500,000.00,YOU HAVE BEEN WARNED!