Legal Document View

Unlock Advanced Research with PRISMAI

Integrated with over 4 crore judgments and laws — designed for legal practitioners, researchers, students and institutions

- Know your Kanoon - Doc Gen Hub - Counter Argument - Case Predict AI - Talk with IK Doc - ...
Upgrade to Premium
[Cites 0, Cited by 0] [Entire Act]

State of Goa - Section

Section 29 in Goa Lotteries (Regulation) Rules, 2003

29. Others.

- The Government may alter or modify these rules as and when it deems it fir to do so.Form I[See Rule 13(2)]Form of Application For Claiming Prize of The Lottery
(1)Date of Application
(2)Name of Claimant (in capital letters)
(3)Full postal address of the Claimant with pin code (in capital letters)
(4)Profession of Claimant
(5)Name of Lottery schemes
(6)Draw No. and date
(7)Ticket No. and series
(8)Category of prizes
(9)Amount of prize
(10)Exercise of options (if any)
(11)If the payment of prize is sought in shape of D.D. name of the nearest Brach of State Bank of India or its subsidiary Bank where it shall be en-cash-able shall be furnished.
(12)The following are enclosed
(i)Prize winning tickets duly signed by the claimant.
(ii)Three copies of passport size photographs of claimant duly attested by a Gazetted Officer/Bank Manager
I solemnly affirm and under take as under:
(i)that I have not won any other lottery prize of Goa State or any other State during the financial year 20.....20 ......
(ii)that I hereby agree and undertake to pay additional income tax/surcharge, if any, required under the Rules
(iii)that I have not made any claim for this prize previously.
...........................Signature of Claimant.
(iv)Received this day the ......of ......20........ the sum of Rs.........in figures) Rupees ............ (in words) being the amount payable on account of the above claim.
(Revenue Stamp)Signature of ClaimantFor Use In Paying Office
(1)The above listed tickets have been verified from the list of prize winning numbers.
(2)Passed for payment of Rs. .........(Rupees ......................................only) after deducting Income Tax @.................% of the prize amount.
1st verified by 2nd verified by  
................................... ........................................ ..........................................
Signature Signature Officer-in-charge of Accounts Paid vide cheque
Paid vide cheque No..........Date.........