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LOTTERY WINNINGS WORKSHEET


So you hit the JackPot--Nice HUH? Problem is you are receiving yearly or monthly payments.

Could you use some cash now? Sell us a payment stream of your future Lottery Payments

and allow yourself to:

  • Purchase A New Home
  • Purchase A New Vehicle
  • Take A dream Vacation
  • Make Investments
  • New Business Venture
  • Or Significantly Improve Your Life-Style

We want to give you Cash Now--All you need to do is provide us with the information below:


NOTE HOLDER INFORMATION: 
Name:* 
Phone:* 
Mailing Address:* 
City:* 
State:* 
Zip Code:* 
PAYMENT INFORMATION: 
State Lottery Was Won:* 
Name Of Casino If Jackpot Was Won:* 
If Casino, What State Was It Located?:* 
Winning Date:* 
Total Prize (Before Taxes) $:* 
Gross Amount Of Check $:* 
Net Amount Of Check $:* 
Date Of Inital Payment:* 
Date Of The Last Payment:* 
Total Amount Is Paid Over How Many Years:* 
Was The Winning Ticket Shared With Others: Yes or No:* 
If Yes How Many:* 
How Much Money Do You Need To Raise $$:* 
Any Additional Comments Or Information: 
 


P.O. Box 4226
Antioch, Illinois  60002
USA

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