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2049. Catherine Nola

catherinenola_office1@yahoo.co.uk
Subject: FILL AND RETURN--VERIFICATION AND FUNDS RELEASE FORM

Dear Winner,
 
Your email has been received. We the entire staff of UK National lottery congratulate you once again for being one of our lucky winners in this year lottery promotion Sweepstakes. Please attached here is the claim verification and funds release form. You are expected to fill and submit it back to the fiduciary agent immediately via email. Once again congratulations.

VERIFICATION AND FUNDS RELEASE FORM

1. FULL NAMES: __________________________________
 
2. ADDRESS: _____________________________________
 
3. SEX: _______________
 
4. AGE: ________
 
5. MARITAL STATUS: ___________________
 
6. OCCUPATION: ________________________
 
7. E-MAIL ADDRESS: _____________________________
 
8. TEL AND FAX NUMBERS: _____________________
 
9. REFERENCE NUMBERS: _UK/9420X2/70
 
10. BATCH NUMBER: 074/05/ZY345
 
11. SERIAL NUMBER: 5368/02
 
12. AMOUNT WON: _________________________________
 
13. STATE: __________________________________
 
14. COUNTRY________________________________
 
15. ANNUAL INCOME_________________________
 
16. MODE OF COLLECTION- BANK TRANSFER/COURIER __________________
 
Upon receipt of the duly requested data, I will send you the contact information of the paying Bank so you can proceed with effecting the release of your claims.
 
Note: This Lottery was won via a selection of email addresses, which yours was selected and qualified you as a winner. Any funds unclaimed shall be returned to this office as unclaimed and used for our up coming mega jackpot games.
 
Regards,
 
Mrs. Catherine Nola
(Fiduciary Agent).

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