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Kansas lottery claim form

How to fill out lottery claim form - Norvegia 2026

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The document is a Winner Claim Form for the Kansas Lottery, which must be submitted along with the winning ticket. It requires personal information from the claimant, including name, address, Social Security Number, and details about the prize. The form includes declarations regarding the accuracy of the information provided and legal ownership of the prize. It also contains a W-9 certification section and instructions for submission.

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Click ‘Get Form’ to open the Lottery Claim Form in the editor.
Begin by printing your last name and first name clearly in the designated fields.
Fill in your address, including city, state, and zip code. If your mailing address differs, provide that information as well.
Enter your Social Security Number (SSN) or Individual Taxpayer Identification Number (ITIN), gender, date of birth, and phone number.
Indicate whether you are a U.S. citizen by selecting 'Yes' or 'No'.
Specify the amount of the prize you are claiming and include your ticket number.
Sign and date the form at the bottom to confirm that all information is accurate and true.
Complete the W-9 certification section by signing and dating it as well.
Finally, bring or mail your signed ticket along with this completed claim form to the Kansas Lottery Claims address provided.

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