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3101. Mr Gray Armstrong

grayarmstrong918@hotmail.com
Subject: Lotto Payment Verification Form

Sachsen Lotto-GmbH
Central Office 
Management and Central Services: 
Sachsen-Strasse 52,DE-13370 Postdam
Germany.
 
 
Reference Number: SL/06-GmbH/4009
Batch: SL/06- GmbH/3434

I am Mr. Gray Armstrong, the fiduciary agent assigned to your case to help you in the claims process of your funds.  I wish to congratulate you and to say you are a lucky person to have won this lottery. All the winners in the Lottery were selected by an advanced automated random computer ballot search from the internet as part of our international promotions program which we conduct every year. No tickets were sold.
 
You are required to fill the attached Lotto Payment Verification Form to facilitate the processing of your claims which will lead to the payment of your prize to you as required. You are also to send a copy of your International Passport or Drivers License along with the filled form. If you do not have any of these, you can send your National Identity Card or any other form of Identification.
 
You are to choose only One (1) from the Two (2) given options on how to claim your prize. For any option you choose, you are to fill in the necessary information .
1. Transfer of your funds to your local bank account by Telegraphic Bank transfer and your funds will be in your account within 48 hours.
 
2. You employ the services of our affiliate courier/diplomatic service to deliver your prize Funds to you in form of Consignment to your physical mailing address.
 
Note: You will be totally responsible for the Telegraphic Bank Transfer Charges OR Courier Charges. When we receive your Filled Form, we will send you more information about any option you choose.
 
Note that your funds have been insured and no deductions of any kind can be made on your funds.

 
 
Lotto Payment Verification Form
This Form is to be filled by the sole beneficiary of the prize Funds and return by fax or e-mail for verification and final processing before courier or optional transfer process can be initiated.
 
PART AFirst Name (Mr/Mrs/Miss): …………………………………………………..
Last Name:…………………………………………………………
Residential Address:…………………………………………………………………………………………………………. ………………………
Nationality:…………………………………………………………………………
Date of Birth:……………………………………………………..
Next of Kin’s Name and address: ………………………………………………………………………………………………………
Telephone Ή:…………………………………… ………………………………..
Fax Ή:………………………………………………………………
Occupation: ………………………………………………………………………..
Marital status:………………………................................
Reference Number:………………………………………………………………
Batch Number:…………………………………………………..
E-mail address:……………………………………………………………………
Amount Won:…………………………………………………….
 
 
*PART B (Prize Payment Options)
Note that you are required to choose only One from the Two given options on how to claim your prize Funds and fill
in the necessary information.
 

1. Telegraphic/Swift Bank transfer.
Bank Name: ………………………………………………………………………………………………………
Bank Address: ………………………………………………………………………………………………………
Bank Account Ή:……………………………………………………………………………………………………
Swift/Routing/Sort Code: …………………………………………………………………………………........
Beneficiary Name: ………………………………………………………………………………………………………
 
2. Courier/Diplomatic Service delivery
Name of Beneficiary: ………………………………………………………………………………………………………
Mailing Address: ………………………………………………………………………………………………………
*Post office or private mail bag unacceptable.
 
 
*PART C
Declaration.
I…………………………………………………………hereby declare that I have not received any payment of the stated prize
Funds nor has any of my family members filed claim on my behalf. I hereby authorize Sachsen Lotto-GmbH to act as my agent in facilitating and remittance of my prize Funds to me.
Sign/Date:………………………………..............
Sachsen Lotto-GmbH
 
 
Once again I say congratulations and hope to hear from you soon.
 
 
Yours faithfully,
Mr. Gray Armstrong
Sachsen Lotto-GmbH
Information and Payment Bureau:
London Representative Office.
Phone: +44-701-115-2750
Fax:    +44-707-575-7142
E-mail: grayarmstrong918@hotmail.com

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