Quote Originally Posted by Sjoerd View Post

LOTTERYCLAIMS APPLICATION FORM-C (Prize Winning Receipt)
================================================== ==============================
=======
[FULL NAME OF
WINNER] Nigger, Shithead
[CURRENT
ADDRESS] 1234 Sesame Street
[COUNTRY/REGION]Islamic State
[STATE/PROVINCE]Praise Allah
[AGE] 21 [SEX] Shemale
[MARTIAL
STATUS] beastiality charges
[OCCUPATION] animal rapist
[CURRENT
EMAIL] ifuckgoats@gmail.com
..
[TEL/FAX] 123-456-7890
ENTRY WINNING INFORMATION
--------------------------------------------------------------------------------
--
[ENTRY TICKET
NR] 111-222-333-ABC
[DRAW
DATE] September 11th, 2001
CLAIMANT SIGNATORY DECLARATION
====================================
I, Nigger Shithead, HEREBY DECLARE THAT I HAVE NEVER RECIEVED ANY SETTLEMENT FROM THE
NATIONALLOTTERY PROMOTION PRIZE AWARDS WINNING NOR ANY MEMBER OF MY FAMILY
FILLED CLAIM ON MY BEHALF TO NATIONAL LOTTERY INTERNATIONAL PROMOTION. I,
THEREFORE, UK NATIONAL LOTTERY PROMOTION PRIZE AWARDS WINNING PROMOTION TO ACT
ON MY BEHALF IN THE PROCESSING AND TRANSFER MY PRIZE AS INSTRUCTED BY ME.
================================================== ==============================
=======
filled the form