Are you one of the thousands of people who applied for a spot in the state’s Sc Ed Lottery? If so, you will want to familiarize yourself with the claim form that is required in order to receive your seat. The form can be daunting, but don’t worry – we’re here to help. In this post, we will outline everything you need to know about the Sc Ed Lottery claim form. We will provide step-by-step instructions on how to complete the form, as well as information on what documents you will need to submit.
Listed below are some specifics about sc ed lottery claim form. You may learn its length, the actual time required to prepare the form, the blanks you will have to fill in, and so forth.
Question | Answer |
---|---|
Form Name | Sc Ed Lottery Claim Form |
Form Length | 2 pages |
Fillable? | No |
Fillable fields | 0 |
Avg. time to fill out | 30 sec |
Other names | sc lottery claim form, south carolina education lottery claim center, scel, sc education claim form |
PAGES 1 AND 2 OF THIS DOCUMENT
MUST BE MAILED TO THE CLAIMS CENTER.
|
|
|
|
|
|
|
|
OFFICIAL USE ONLY |
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
ONLINE |
|
INSTANT |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
|
|
ONLINE |
|
INSTANT |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
ONLY |
|
ONLINE |
|
INSTANT |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
ONLINE |
|
INSTANT |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
USE |
|
|
|
|
PRIZE AMOUNT |
$ |
|
|
|
|
|
|
|
, |
|
|
|
|
|
|
|
, |
|
|
|
|
|
|
|
. |
|
|
|
|
|
|||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||
|
TYPE OF I.D.: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
NUMBER: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
OFFICIAL |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||
(Driver’s License, Passport, Military, or State I.D.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||||||||
|
|
AUTHORIZED SIGNATURE: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||
|
|
OFFICIAL’S NAME: (Please Print) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||
|
CLAIM NUMBER PROVIDED BY |
DATE |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||||||||
|
S.C. EDUCATION LOTTERY |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
- |
|
|
|
|
|
|
- |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
CLAIMS
FORM
Columbia Claims Center
1309 Assembly Street
Columbia, SC 29201
Phone: (803)
8:30 a.m. - 5:00 p.m.
(EXCEPT CERTAIN STATE HOLIDAYS) Players should arrive by 4 p.m. to allow time to verify winning ticket(s).
Claims in excess of $500 must include:
(1)this form and (2) a copy of an identi tion card (driver’s license, passport, military, or state I.D.) that includes a photo and date of birth.
INSTRUCTIONS:
1.Complete the form on the reverse side entirely. Use one character per box.
2.Sign and date the reverse side of this form.
3.Sign and attach the Winning Ticket(s) to this form.
Mailing Address:
S.C. Education Lottery
P.O. Box 11039
Columbia, SC
The risk of mailing ticket(s) remains with the claimant. Winnings greater than $100,000 must be redeemed in person at the Columbia Claims Center.
NAME
Mr.
Ms.
MAILING ADDRESS
CITY |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
STATE |
|
|
ZIP |
|
|||||||||||||||||||||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
- |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PHONE |
|
|
|
|
|
|
|
|
|
DATE OF BIRTH |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||
|
|
|
- |
|
|
|
- |
|
|
|
|
|
|
|
|
- |
|
|
- |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
TAX STATUS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
||||
|
U.S. CITIZEN OR RESIDENT ALIEN |
SOCIAL SECURITY NO. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||||||
CHECK ONE BOX |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|||||||||||||||||||||
NOT U.S. CITIZEN; NOT RESIDENT ALIEN. Country of citizenship must be provided below. You do not have to be a U.S. Citizen |
|
|||||||||||||||||||||||||||||||||||||||||||||||||||
|
|
|
|
|
to claim a prize; however, YOU MUST indicate status for tax purposes. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
COUNTRY
Knowingly presenting a counterfeit, altered, or stolen lottery ticket or knowingly ts that are untrue is in violation
of South Carolina Law. Debts owed to South Carolina or its political subdivisions may be deducted from winnings. Multiple tickets presented at the same time will be combined. If the total winnings exceed $500, applicable taxes will be withheld. Under penalty of perjury, I declare to the best of my knowledge and belief all information provided on this form, such as my name, address, and Social Security number is correct. You must check “Yes” or “No” for each of the following:
Yes No
I am the only person entitled to any part of this payment. Claimants receiving more than $500 will receive a
I am claiming the prize as a member of a winning group designated on the attached IRS Form 5754. Only one check will be issued. For more information or to obtain IRS Form 5754, call (803)
I authorize the South Carolina Education Lottery (SCEL) to use any photographic or
INFORMATION FROM THIS FORM MAY BE SUBJECT TO DISCLOSURE UNDER THE S.C. FREEDOM OF INFORMATION ACT (FOIA). I release SCEL from all liability or claims relating to information provided to or used by a party obtaining information pursuant to FOIA.
By signing this form, I attest that I am at least eighteen (18) years of age and that I am eligible to claim a lottery prize pursuant to the laws and regulations governing the operation of the Lottery and that all information provided (including the boxes checked above) is true and accurate.
CLAIMANT’S SIGNATURE: |
|
DATE: |