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PlasmaNet Inc.
P.O. BOX 4562,
NEW YORK, NY 10163
barcode
Respond by: October 1st, 2014
201312
CERTIFIED WINNER CLAIM FORM
• Samsung 65" 3D LED Smart TV
• Dell Inspiron Laptop Computer
• Apple iPad Mini
• $50.00 SkyAuction Savings Certificate
Use the form below to claim your prize. You are a guaranteed winner of one of the prizes listed to the left.
Authorized by:   B. Kelleher
• Samsung 65" 3D LED Smart TV
• Dell Inspiron Laptop Computer
• Apple iPad Mini
• $50.00 SkyAuction Savings Certificate
Use the form below to claim your prize. You are a guaranteed winner of one of the prizes listed above.
Code No. PSN20121205
Section A: Grand Prize Value Disclosure
You have been directed to this prize claim form because you are a verified and confirmed winner of one of the prizes listed above. The Grand Prize value is:
$3,500.00
Section B: Claim Information
Note: You are a guaranteed winner of one of the prizes listed above. Fill out the form below to claim your prize.
Failure to complete this form in its entirety may result in forfeiture of your prize.
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Your prize notification and FreeLotto entry confirmations, daily results and sponsored advertising messages will be sent by e-mail only from FreeLotto:
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This confirmation is contingent upon meeting the age and residency requirement. These prizes are being offered by FreeLotto.com as part of a worldwide publicity campaign. Offer is valid for a limited time.
By clicking on “CLAIM NOW” above, I acknowledge that I have read the Official Rules, Sweepstakes Rules and FreeLotto Privacy Policy and agree to be bound by them.
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