Claim Form CLAIM YOUR MONEY : If your lottery ticket number matches with the results claim your money . Ticket Number : *Ticket Name :Ticket Name :OpalTopazSilverGoldPlatinumDiamondPurchased Date : *Result Date : *Amount own of the customer : *Personal DetailsOccupation or Profession : *City : *District : *State : *Country : *Postal Code : *Telephone Number :Mobile Number : *Date Of Birth : *Gender : *Male FemaleMarital Status : *MarriedUnMarriedAddress : *Bank Details(Optional)Account number :Bank Name :Branch :Account name :IFSC :PAN number if any :SUBMIT Those who feel difficulty to claim the prize 9 CONTACT US