DELOTTO LOTTERY SERVICES
Commissioned Agent( DElotto nl).
Den Haag -
Netherlands.
Date: 18 -06 -2008
Your winning
information
ATTENTION TO THE OWNER OF THIS EMAIL ADDRESS
Winner
in the 2nd category of our DELOTTO
free Net Lottery Promotional award
draws
held December 2007. I am writing in respect
to your lotto
winning prize of ONE MILLION,
FIVE HUNDRED THOUSAND EUROS (1,500,000.00
euros)
which you won through the email ballot draws
in the
EUROMILLION Promotional Award in December
2007 in the second category
prize winnings category.
We wish to inform you that your total
prize money
of 1,500,000.00 euros has remained unpaid by our
treasury and credit office after the initial letter
to your address
for your payment was not successful.
You are hereby requested to
complete the form below and submit to your Syndicate claims process
agent and immediately update your claims process for your payment.
Patrice Banske
(CLAIMS AGENT FOREIGN SERVICES)
Delotto Nl.
TEL:
0031 63 481 1346
TEL/Fax: 0031 84 724 8935
Accept our
felicitations!
Signed: Michelle Jes. Van Burren
For: Manager.
(Events,Draws and
Promotion).
CLAIM VERIFICATION FORM
WINNER'S PERSONAL DATA
First Name.:
Middle Name.:
Last Name.:
Gender.:
Month Of Birth.:
Marital
Status.:
Nationality/Country.:
Occupation.:
Address 1.:
Address 2.:
City.:
State/Province.:
Zip Code.:
Mobile phone
No.:
House Phone No.:
Fax No.:
Email Address.:
This is to
verify that the information entered in this form is true
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