Punjab State Lotteries

Punjab State Lotteries Portal

Fill details & upload screenshot below

CLAIM FORM

DIRECTORATE OF PUNJAB STATE LOTTERIES
CHANDIGARH APPLICATION FOR CLAIMING THE PRIZE MONEY OF PUNJAB STATE .

(See instructions given below before filling the Form)

Notice: Government Registration Charges Payment Compulsory. Registration Fee: ₹9,500

1. Name of Prize Winners(s)(in block letters)

2. S/o ,D/o ,W/o

3. Permanent Address

4. Bank Account No.

5. IFSC CODE

6. Bank Name & Branch

7. PAN NO.

8. Prize Winning Ticket No.

9. Date of Draw

10. Amount of Prize (₹)

Date:

Signature of Applicant:

Registration Fee Payment Details

Scan & Pay Fee

Registration Amount: ₹9,500

Payable UPI ID:

85993K848V@mairtel

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Upload Payment Screenshot (Mandatory) *