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The California Scratchers form serves as a crucial tool for individuals claiming their lottery winnings, particularly for prizes of $599 or less. It is essential to understand the various components of this form to ensure a smooth and efficient claim process. Claimants must provide personal information, including their full name, address, date of birth, and Social Security Number or Tax Identification Number. This information is vital for tax purposes and to verify the identity of the winner. The form also requires details about the winning ticket, such as the ticket number and the claimed prize amount. An original ticket must be attached, with the claimant's signature matching the one on the ticket itself. Additionally, the form includes instructions for submission, emphasizing the importance of accuracy and completeness to avoid delays. Claimants should be aware that processing claims can take approximately eight weeks and that federal taxes may be withheld based on citizenship status. Furthermore, the form highlights privacy considerations, assuring claimants that their personal information will be protected while also noting that certain details, such as the winner's name and prize amount, may be subject to public disclosure. Understanding these aspects can help ensure that your claim is processed without unnecessary complications.
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Cash all prizes of $599 or less at participating Lottery Retailers
CLAIMANT INFORMATION PLEASE READ ALL INFORMATION AND INSTRUCTIONS BEFORE COMPLETING CLAIM FORM
LAST NAME
FIRST NAME
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ADDRESS 2
CITY
COUNTRY
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MONTH |
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YEAR |
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SUFFIX |
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SSN/TIN |
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PHONE |
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AREA CODE |
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I am a Lottery Retailer
I am employed by a Lottery Retailer I am related to a Lottery Retailer
Check one (for tax purposes only):
I do not have a Social Security Number
I am not a U.S. Citizen, and I am not a Resident Alien
TICKET INFORMATION
Attach the original ticket to this form with your legal name, signature and address showing. Enter the
information below (Scratchers
Ticket Number:
Prize Claim: $
I declare, under penalty of perjury under the laws of the State of California, including but not limited to California Penal Code §§ 118 and 72, that I am the rightful owner of the ticket on this form, that I am 18 years of age or older, and that all information provided is true and correct. I understand that any person who, with intent to defraud, falsely makes, alters, forges or counterfeits a Lottery ticket is in violation of state law and could be liable for criminal penalties.
Claimant Signature |
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Date |
(Only one signature, and it must match signature on ticket)
FOR DISTRICT OFFICE USE ONLY
PLAYER I.D. CODE |
DIST. OFFICE CODE |
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DATE RECEIVED |
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DRAW DATE |
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INITIALS |
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FOR HEADQUARTER OFFICE USE ONLY
POST MARK DATE
CODE(S)
REASON
RELEASED
CRN
CSL 1242 (R7/19) |
Page 1 of 3 |
PRIZE PAYMENT INFORMATION
Failure to provide your original signed ticket with date of birth, legal name, complete address (including apartment or space number, city, state, zip code), email and phone number may delay or prevent the California State Lottery (Lottery) from processing your prize claim. Claims submitted to Lottery Headquarters for processing are paid by check and mailed from the California State Controller's Office. Processing time, once claim is received and verified, is approximately 8 weeks. If you have questions, contact the Lottery at
Lottery prizes are not subject to California state income tax. The Lottery is required by federal tax law to withhold federal taxes of 24% for U.S. citizens and resident aliens.
Tickets, transactions, purchases, claims and prize payments are subject to federal and state law and California Lottery regulations, policies and procedures. Copies of regulations are available at Lottery District Offices and on our website at www.calottery.com. Tickets failing validation are void.
INSTRUCTIONS
1.Print your legal name, street address, city, state, and zip code on the back of the ticket.
2.Sign your name on the back of the original ticket.
3.Complete the Claimant Information and Ticket Information sections on the first page of thisform.
4.Sign the first page of this form with ink. (ONLY ONE SIGNATURE IS PERMITTED)
5.Staple your original ticket to the front of this form.
KEEP A COPY OF THIS FORM AND A COPY OF THE FRONT AND BACK OF THE TICKET.
Deliver the completed claim form with original ticket to any Lottery District Office. Location and directions can be found at www.calottery.com.
OR, MAIL THIS CLAIM FORM, AT YOUR OWN RISK, WITH THE ORIGINAL TICKET STAPLED ON THE FRONT, TO: California Lottery, 730 North 10th Street, Sacramento, CA
Call
PRIVACY NOTICE
The Information Practices Act of 1977 (Cal. Civ. Code
The Claimant Information requested on this form will be used to validate and process your claim in accordance with the California State Lottery Act of 1984 (Gov. Code §8880 et seq.). The Lottery requests a player's social security or
tax identification number (SSN/TIN) for tax withholding and reporting purposes, pursuant to Internal Revenue Code
§§6011, 6041, 6109, 3402, and the regulations enacted thereunder.
The Claimant Information you provide may be disclosed to various state and federal government agencies, including but not limited to: the State Controller's Office, Franchise Tax Board, Health and Welfare Agency, and the Internal Revenue Service. It will not be disclosed to members of the public.
You have the right to access your personal information maintained by the Lottery by contacting the California Lottery, 700 North 10th Street, Sacramento, CA
Purpose and Relevancy of Information Collected: Information is collected to validate and process a claim and for purposes of sales, marketing, research, security investigation, legal review, surveys, and strategic planning as related to the operations of the Lottery. By submitting this claim, you consent and agree to such use, and waive any and all legal claims, known or unknown, related to the specified uses set forth herein. The California Lottery is subject to public disclosure laws that allow access to certain governmental records. Your full name, the name and location of the retailer who sold you the winning ticket, the date you won, and the amount of your winnings, including your gross and net installment payments, are matters of public record and are subject to disclosure. The Lottery will not disclose any other personal or identifying information without your permission unless legally required to do so. No information will be collected or accepted from known minors. You may be asked to participate in a press conference.
CSL 1242 (R7/19) |
Page 2 of 3 |
VOLUNTARY DEMOGRAPHIC INFORMATION
By volunteering to answer the following questions, you will help the Lottery know more about its players. The voluntary information that you provide regarding your ethnicity, household income, gender, and household composition will be used only by the Lottery to conduct internal demographic analyses (which may be completed by agents and contractors).
Which of the following do you consider yourself to be?
(Check all that apply)
African American
Asian
Hispanic
White
Other (Specify)
Annual Household Income
Under $30,000
$30,000 TO $49,999 $50,000 TO $99,999
$100,000 TO $149,999
$150,000 or more
Number of People in Household
(including yourself):
Gender
Female
Male
Nonbinary
CSL 1242 (R7/19) |
Page 3 of 3 |
Form Specifications
| Fact Name | Description |
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| Claim Amount | Prizes of $599 or less can be cashed at participating Lottery Retailers. |
| Eligibility Age | Claimants must be 18 years of age or older to submit a claim. |
| Required Information | Claimants must provide their legal name, address, date of birth, and contact information. |
| Tax Withholding | U.S. citizens and resident aliens have 24% of their winnings withheld for federal taxes. |
| Non-Citizen Tax Rate | Non-U.S. citizens will have 30% withheld from all prizes for federal tax purposes. |
| Processing Time | Claims are processed in approximately 8 weeks once received and verified. |
| Governing Law | The California Lottery Act of 1984 (Gov. Code §8880 et seq.) governs the claim process. |
| Privacy Notice | Personal information is collected to validate claims and may be shared with certain government agencies. |
California Scratchers: Usage Guidelines
Filling out the California Scratchers form is an important step to claim your prize. Make sure you have your winning ticket ready, as you'll need to attach it to the form. Follow these steps carefully to ensure everything is completed correctly.
- Print your legal name, street address, city, state, and zip code on the back of the ticket.
- Sign your name on the back of the original ticket.
- Complete the Claimant Information and Ticket Information sections on the first page of the form.
- Sign the first page of the form with ink. Remember, only one signature is allowed.
- Staple your original ticket to the front of the form.
- Keep a copy of the form and a copy of the front and back of the ticket for your records.
- Deliver the completed claim form with the original ticket to any Lottery District Office. You can find locations and directions at www.calottery.com.
- Alternatively, you can mail the claim form, at your own risk, with the original ticket stapled on the front, to: California Lottery, 730 North 10th Street, Sacramento, CA 95811-0336.
Your Questions, Answered
What is the California Scratchers form used for?
The California Scratchers form is used to claim prizes from Scratchers tickets. If you have won a prize of $599 or less, you can cash it at participating Lottery Retailers. For prizes over $599, you must complete this form and submit it along with your original ticket to the California Lottery for processing.
How do I fill out the Claimant Information section?
In the Claimant Information section, you need to provide your last name, first name, address, city, state, zip code, date of birth, and contact information, including email and phone number. Ensure that all information is accurate and matches your identification. If you do not have a Social Security Number, you must indicate that on the form.
What happens if I fail to provide the original ticket?
If you do not attach the original signed ticket to your claim form, your prize claim may be delayed or even denied. The original ticket serves as proof of ownership and is essential for processing your claim. Always keep a copy of the ticket and the completed form for your records.
How long does it take to process my claim?
Once the California Lottery receives and verifies your claim, the processing time is approximately 8 weeks. If you have any questions during this period, you can contact the Lottery at 1-800-LOTTERY (568-8379) on weekdays for assistance.
Are lottery prizes subject to taxes?
Lottery prizes are not subject to California state income tax. However, federal tax law requires withholding of 24% for U.S. citizens and resident aliens. If you are a non-U.S. citizen, 30% will be withheld from your winnings. Be aware of these tax implications when claiming your prize.
What should I do if I have multiple winning tickets?
If you have more than one winning ticket, you must complete a separate claim form for each ticket. Attach the original ticket to its respective form and submit them individually. For group claims of prizes over $1,000,000, you should request a Multiple Ownership Claim form from the Lottery.
Common mistakes
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Incomplete Personal Information: Many people forget to fill out all required fields, such as their last name, first name, or address. It's essential to provide complete and accurate information to avoid delays.
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Missing Signature: A common mistake is failing to sign the claim form. Ensure that your signature matches the one on the back of your ticket, as only one signature is allowed.
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Incorrect Ticket Number: Some individuals mistakenly enter the wrong ticket number. Always double-check that the number provided matches the one on your ticket.
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Not Attaching the Original Ticket: People often forget to staple the original ticket to the claim form. Remember, the original ticket is necessary for processing your claim.
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Ignoring the Age Requirement: Claimants must be at least 18 years old. Some individuals may overlook this requirement, which could lead to disqualification.
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Providing Incorrect Contact Information: If the email or phone number is incorrect, it can hinder communication regarding your claim. Always verify that your contact details are accurate.
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Failing to Keep Copies: Many forget to make copies of the claim form and ticket before submitting. Keeping copies can be helpful for your records and in case of any issues.
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Mailing Without Tracking: Some people send their claim forms without tracking options. It's advisable to use a method that allows you to track your submission to ensure it arrives safely.
Documents used along the form
When submitting a claim for a California Scratchers ticket, there are several other forms and documents that you may need to be aware of. Each of these documents serves a specific purpose in the claim process, ensuring that everything is handled correctly and efficiently.
- Claim Form for Multiple Ownership: This form is used when a group of players, typically fewer than 100, is sharing a prize of $1,000,000 or more. It allows all members to be recognized in the claim process.
- W-9 Form: This form is required for U.S. citizens and resident aliens to provide their taxpayer identification number. It helps the Lottery report any winnings to the IRS for tax purposes.
- W-8 BEN Form: Non-U.S. citizens must complete this form to certify their foreign status. It is important for tax withholding purposes, as different rates apply to non-residents.
- Identity Verification Documents: These may include a driver’s license, passport, or other forms of ID. They help verify the identity of the claimant, ensuring that the prize goes to the rightful owner.
- Affidavit of Ownership: This document may be required to affirm that the claimant is indeed the owner of the winning ticket. It serves as a legal declaration under penalty of perjury.
- Power of Attorney: If someone else is claiming the prize on behalf of the winner, this form allows them to act legally on the winner's behalf, ensuring all claims are valid.
- Tax Withholding Notification: This document outlines the amount of federal tax that will be withheld from the winnings. It is crucial for understanding the net amount the claimant will receive.
- Privacy Notice Acknowledgment: Claimants must acknowledge the privacy notice that explains how their personal information will be used and protected during the claim process.
Understanding these forms can make the claiming process smoother and help avoid delays. Always ensure that you have the necessary documents ready when submitting your claim for a California Scratchers ticket.
Similar forms
- W-2 Form: This document reports an employee's annual wages and the taxes withheld from their paycheck. Like the Scratchers form, it requires personal information and is used for tax purposes.
- 1099 Form: Used to report income received by independent contractors. Similar to the Scratchers form, it collects claimant information for tax reporting.
- Claim for Refund (IRS Form 843): This form is used to request a refund of certain taxes. It also requires detailed personal information and a declaration of truthfulness.
- State Tax Return: Similar in that it requires personal information and is used to report income for tax purposes. It often involves claiming deductions and credits.
- Power of Attorney Form: This document allows someone to act on behalf of another. Like the Scratchers form, it requires signatures and personal information to validate authority.
- Insurance Claim Form: Used to claim benefits from an insurance policy. It requires personal details and a declaration of the claim's legitimacy, much like the Scratchers form.
- Passport Application: This document requires personal information and proof of identity. It also involves a declaration of truthfulness similar to the Scratchers form.
- Voter Registration Form: Used to register to vote, this form collects personal information and requires a signature to validate the applicant's identity.
Dos and Don'ts
When filling out the California Scratchers form, keep the following tips in mind:
- Do print your legal name clearly on the form.
- Do sign the back of the original ticket.
- Do include your complete address, including apartment or space number.
- Don't forget to staple the original ticket to the front of the claim form.
- Don't use a pencil or any form of ink that could smudge.
- Don't submit your claim without ensuring all information is accurate and complete.
Misconceptions
Misconceptions about the California Scratchers form can lead to confusion for claimants. Here are six common misunderstandings:
- All prizes can be claimed at any retailer. Many believe they can cash in any winning ticket at any Lottery Retailer. However, only prizes of $599 or less can be cashed at participating retailers. Larger prizes must be claimed through the Lottery directly.
- Only U.S. citizens can claim prizes. Some people think that only U.S. citizens are eligible to claim lottery winnings. In reality, non-U.S. citizens can also claim prizes, but they will face different tax withholding rates.
- The claim form is optional for small prizes. A misconception exists that the claim form isn’t necessary for small prizes. In truth, even for prizes under $600, the form is required to ensure proper processing and record-keeping.
- Claims can be submitted without the original ticket. Many individuals mistakenly believe they can submit a claim without the original ticket. The California Lottery requires the original ticket to be attached to the claim form for verification purposes.
- All personal information is kept private. While most information is protected, some details about winners, such as names and prize amounts, are public records. This is often overlooked by claimants.
- Claiming a prize is an instant process. Some expect immediate payment upon submitting their claim. However, the processing time can take approximately eight weeks once the claim is received and verified.
Key takeaways
Filling out and using the California Scratchers form requires attention to detail. Here are some key takeaways to keep in mind:
- Claiming Small Prizes: You can cash all prizes of $599 or less at participating Lottery Retailers without needing to fill out the claim form.
- Original Ticket Required: Always attach the original ticket to the claim form. Ensure your legal name, signature, and address are visible on the ticket.
- Processing Time: After submitting your claim to Lottery Headquarters, expect a processing time of approximately 8 weeks before receiving your prize.
- Tax Information: Be aware that while California Lottery prizes are not subject to state income tax, federal taxes will be withheld based on your citizenship status.
- Privacy Matters: The information you provide is used solely for validating and processing your claim, and it will not be disclosed publicly without your permission.
By following these guidelines, you can navigate the process more smoothly and ensure your claim is handled efficiently.