Homepage Blank California Scratchers Form
Outline

The California Scratchers form is an essential document for anyone wishing to claim their lottery winnings. This form facilitates the process of cashing in prizes of $599 or less at participating Lottery Retailers. Claimants must provide detailed personal information, including their name, address, date of birth, and Social Security Number or Tax Identification Number, if applicable. It's crucial to attach the original winning ticket to the form, ensuring that your legal name, signature, and address are visible. The form also includes sections for ticket information, requiring the ticket number and prize claim amount. Additionally, it outlines the necessary steps for submission, whether in person at a Lottery District Office or via mail. Claimants must declare their rightful ownership of the ticket and acknowledge the legal implications of providing false information. Understanding the privacy policies related to the information collected is also vital, as this data is used for validation and processing claims in accordance with state law. With clear instructions and a straightforward structure, the California Scratchers form aims to make the claiming process as seamless as possible for winners.

Sample - California Scratchers Form

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
MI
SUFFIX
DATE OF BIRTH
MONTH
-
DAY
-
YEAR
SSN/TIN
-
-
ADDRESS 1
ADDRESS 2
CITY
STATE
ZIP CODE
-
COUNTRY
E-MAIL
PHONE
AREA CODE
- -
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 13-18 digit ticket number is located on back of ticket; Draw Game 18 digit ticket number
is located on front of ticket). Attach another claim form for more than one ticket.
Ticket Number:
CSL 1242 (R7/19)
Page 1 of 3
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
(Only one signature, and it must match signature on ticket)
Date
FOR DISTRICT OFFICE USE ONLY
PLAYER I.D. CODE
DIST. OFFICE CODE
DATE RECEIVED
DRAW DATE
INITIALS
FOR HEADQUARTER OFFICE USE ONLY
POST MARK DATE
CODE(S)
REASON
RELEASED
CRN
Sign the first page of this form with ink. (ONLY ONE SIGNATURE IS PERMITTED)
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 1-800-
LOTTERY (568-8379), Monday through Friday.
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. Non-US citizens will have 30% withheld from all prizes.
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
Ticke
t Information
sections on the first page of thisform.
4.
5. Staple you
r original ticket to the front of this form.
CSL 1242 (R7/19)
Page 2 of 3
Deliver the completed claim form with original ticket to any Lo
ttery 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 95811-0
336
Call 1-800-LOTTERY(568-8379), or visit any Lottery
District Office to reques
t a Multiple Ownership Claim
form for group players
(less than 100) sha
ring prizes
of $1,000,000, or mo
re.
KEEP A COPY
OF THIS FORM AND A COPY
OF THE F
RONT AND B
ACK OF THE TICKET.
PRIVACY NOTICE
The Information Practices Act of 1977 (Cal. Civ. Code §§1798-1798.78, the Federal Privacy Act (Public Law 93-579), 5
U.S.C. §552a, and Cal. Gov. Code §§11015.5 and 11019.9, require that this notice be provided when collecting
personal information from individuals.
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 95811-0336 - Attention: Privacy Coordinator, Information Security
Office
-
Security and Law Enforcement Division. The
Privacy Coordinator can also be reached at
916-822-8800 or
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.
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 Information

Fact Name Fact Description
Prize Claim Amount Winners can cash all prizes of $599 or less at participating Lottery Retailers without needing to submit a claim form.
Claimant Age Requirement Claimants must be at least 18 years old to submit a claim for lottery winnings, as stated under California law.
Tax Withholding Federal tax law mandates a 24% withholding for U.S. citizens and resident aliens on winnings, while non-U.S. citizens face a 30% withholding.
Processing Time Once a claim is received and verified, the processing time is approximately 8 weeks before payment is issued.
Privacy Regulations The California Lottery follows the Information Practices Act of 1977 and the Federal Privacy Act to protect personal information collected during the claim process.

Detailed Guide for Filling Out California Scratchers

Filling out the California Scratchers form is a straightforward process. Follow the steps carefully to ensure your claim is processed without delays. Once completed, you can either deliver the form in person to a Lottery District Office or mail it to the designated address.

  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 the form.
  4. Sign the first page of the form with ink. Only one signature is permitted.
  5. Staple your original ticket to the front of the form.
  6. Keep a copy of the form and a copy of the front and back of the ticket for your records.
  7. Deliver the completed claim form with the original ticket to any Lottery District Office, or mail it at your own risk to: California Lottery, 730 North 10th Street, Sacramento, CA 95811-0336.

Obtain Answers on California Scratchers

  1. What is the California Scratchers form used for?

    The California Scratchers form is used to claim prizes won from Scratchers lottery tickets. If you have won a prize of $599 or less, you can cash it directly at participating Lottery Retailers. For prizes over $599, you will need to complete this form and submit it to the California Lottery.

  2. How do I fill out the Claimant Information section?

    In the Claimant Information section, you need to provide your legal name, address, date of birth, Social Security Number (SSN) or Tax Identification Number (TIN), email, and phone number. Make sure to read all instructions carefully to ensure your information is accurate and complete.

  3. What should I do if I have won more than one ticket?

    If you have won more than one ticket, you must attach a separate claim form for each ticket. Ensure that each form is filled out completely and accurately before submission to avoid delays in processing your claims.

  4. What happens if I do not provide my original signed ticket?

    Failure to provide your original signed ticket along with your claim form may delay or prevent the California Lottery from processing your prize claim. It is essential to include the original ticket to validate your claim.

  5. How long does it take to process my claim?

    Once your claim is received and verified, the processing time is approximately 8 weeks. Keep in mind that this timeline may vary based on the volume of claims received by the Lottery.

  6. Are lottery prizes subject to taxes?

    Lottery prizes are not subject to California state income tax. However, federal tax law requires that 24% be withheld from prizes for U.S. citizens and resident aliens. For non-U.S. citizens, 30% will be withheld from all prizes. It’s important to consider these tax implications when claiming your prize.

  7. What should I do if I have questions about my claim?

    If you have questions regarding your claim, you can contact the California Lottery at 1-800-LOTTERY (568-8379) during regular business hours, Monday through Friday. They can provide assistance and clarification on the claims process.

  8. What information is collected on this form?

    The form collects personal information such as your name, address, date of birth, and Social Security Number for the purpose of validating and processing your claim. This information is protected and will not be disclosed to the public without your permission, except as required by law.

  9. Can I participate in a press conference if I win?

    Yes, you may be asked to participate in a press conference if you win a significant prize. This is a common practice for the Lottery to celebrate winners and promote its games. Participation is voluntary, and you can choose whether or not to take part.

Common mistakes

Completing the California Scratchers claim form can be a straightforward process, but there are common mistakes that individuals often make, which can delay their prize claims. Understanding these pitfalls can help ensure a smoother experience.

One frequent error is failing to provide the original ticket. The claim form explicitly states that the original ticket must be attached. Without it, the claim cannot be processed. It is essential to remember that a photocopy or a digital image will not suffice.

Another mistake involves incomplete personal information. Claimants must fill out their legal name, address, date of birth, and contact information accurately. Omitting any of these details, such as the apartment number or a missing zip code, may lead to delays in processing the claim.

Many individuals forget to sign the claim form. The signature must match the one on the back of the ticket. A missing or mismatched signature can result in the rejection of the claim. Therefore, it is crucial to double-check that the signature is present and consistent.

Additionally, some claimants neglect to print their name clearly on the back of the ticket. This step is vital for identification purposes. Illegible handwriting can cause confusion and may lead to complications in verifying ownership of the ticket.

Claimants sometimes overlook the requirement to provide their Social Security Number or Tax Identification Number. This information is necessary for tax purposes, and failing to include it can lead to withholding issues. It is important to check the appropriate box if you do not have a Social Security Number.

Another common mistake is not reading the instructions carefully. The form contains specific directions that must be followed to ensure proper submission. Skipping over these details can result in incomplete forms, which may delay processing.

Some individuals mistakenly believe they can submit claims for multiple tickets on a single form. Each ticket requires its own claim form. Failing to attach separate forms for additional tickets can lead to confusion and delays in processing each claim.

Moreover, claimants often forget to keep a copy of their completed claim form and the ticket. Having a record of what was submitted can be invaluable if there are any questions or issues that arise during the processing of the claim.

Lastly, mailing the claim form without proper tracking can pose a risk. If the form and ticket are lost in transit, it can result in the loss of the prize. It is advisable to use a method that provides confirmation of delivery to ensure that the claim reaches the California Lottery safely.

Documents used along the form

The California Scratchers form is an essential document for claiming lottery prizes. Along with this form, several other documents may be required or helpful in the process of claiming winnings. Below is a list of additional forms and documents that are often used in conjunction with the California Scratchers form.

  • Claim Form for Multiple Ownership: This form is necessary for groups of players who share a winning ticket worth $1,000,000 or more. It ensures that all parties involved are recognized and compensated accordingly.
  • W-2G Form: This tax form is issued by the lottery to report gambling winnings. It is important for tax purposes, particularly for winners who exceed certain thresholds.
  • IRS Form 1040: This is the standard federal income tax return form. Winners must report their lottery winnings as income on this form when filing their taxes.
  • California State Tax Form 540: This form is used for California state income tax returns. While lottery winnings are not subject to state tax, this form may still be relevant for overall tax reporting.
  • Identification Documents: A government-issued ID, such as a driver's license or passport, is typically required to verify the identity of the claimant.
  • Social Security Card: This may be requested to confirm the claimant's Social Security Number for tax withholding purposes.
  • Power of Attorney Document: If someone else is claiming the prize on behalf of the winner, a Power of Attorney may be necessary to authorize this action legally.
  • Affidavit of Ownership: This document may be required to confirm that the claimant is indeed the rightful owner of the winning ticket.
  • Privacy Notice: This document outlines how personal information will be handled and is important for understanding the privacy implications of claiming a lottery prize.

Being prepared with these additional forms and documents can streamline the process of claiming lottery winnings. It is advisable to keep copies of all submitted materials for personal records. This ensures that any potential issues can be addressed promptly and effectively.

Similar forms

The California Scratchers form is essential for claiming lottery prizes, and it shares similarities with several other documents used for various claims and applications. Here’s a list of nine documents that resemble the California Scratchers form in purpose and structure:

  • IRS Form W-2: This form is used by employers to report wages and tax withheld for employees. Like the Scratchers form, it requires personal information and is crucial for tax reporting.
  • Claim for Refund Form (IRS Form 1040X): Individuals use this form to amend their tax returns. It shares the need for accurate personal details and a declaration of the claim being made.
  • Insurance Claim Form: This document is submitted to request payment for a covered loss. Similar to the Scratchers form, it requires claimant information and details about the claim.
  • Social Security Administration Form SSA-1099: This form reports Social Security benefits received. It includes personal data and tax information, much like the Scratchers form's tax reporting aspect.
  • Unemployment Benefits Application: When applying for unemployment benefits, individuals must provide personal information and details about their employment history, paralleling the information required on the Scratchers form.
  • Medicare Application Form: This form is used to enroll in Medicare. It requires personal details and declarations, similar to the Scratchers form's claimant information section.
  • Property Tax Exemption Application: Homeowners use this form to claim tax exemptions. It requires detailed personal information and a declaration of eligibility, akin to the Scratchers form.
  • Food Assistance Program Application: This application is used to request food assistance benefits. It requires personal information and income details, much like the Scratchers form.
  • Student Financial Aid Application (FAFSA): Students use this form to apply for financial aid for college. It requires detailed personal and financial information, similar to the requirements on the Scratchers form.

Each of these documents plays a crucial role in processing claims or applications, necessitating personal information and formal declarations from the claimant.

Dos and Don'ts

When filling out the California Scratchers form, there are several important actions to take and avoid. Here is a list of what you should and shouldn't do:

  • Do print your legal name clearly on the form.
  • Do include your complete address, including apartment or space number.
  • Do sign the back of the original ticket.
  • Do staple your original ticket to the front of the claim form.
  • Do keep a copy of the claim form and the ticket for your records.
  • Don't forget to provide your date of birth.
  • Don't use more than one signature on the claim form.
  • Don't mail the form without stapling the original ticket to it.
  • Don't submit a claim without ensuring all information is accurate and complete.

Misconceptions

Misconceptions about the California Scratchers form can lead to confusion and delays in processing claims. Here are five common misconceptions, along with clarifications to help ensure a smoother experience.

  • Claiming Prizes Over $599 is the Same as Claiming Under $599: Many people believe that the process for claiming prizes over $599 is identical to that for smaller amounts. In reality, prizes of $599 or less can be claimed directly at participating Lottery Retailers, while amounts above $599 require submission of a claim form and the original ticket to a Lottery District Office.
  • All Information is Optional: Some claimants think that they can skip certain sections of the form. However, providing complete and accurate information is crucial. Missing details can delay the processing of your claim or even result in its rejection.
  • Only U.S. Citizens Can Claim Prizes: A common misconception is that only U.S. citizens are eligible to claim lottery prizes. In fact, non-U.S. citizens can also claim prizes, but they may be subject to different tax withholding rates.
  • Signing the Ticket is Not Necessary: Some individuals believe that they do not need to sign the back of their ticket. This is incorrect; signing the ticket is a required step to validate ownership and prevent fraud.
  • The Claim Form is Only for Individual Players: Many assume that the claim form is only for individual winners. However, there is a provision for group claims, allowing multiple players to claim a prize together, especially for significant winnings.

Understanding these misconceptions can help ensure that your lottery claim is processed efficiently and accurately. Always read the instructions carefully and provide all required information to avoid complications.

Key takeaways

When filling out and using the California Scratchers form, keep these key points in mind:

  • Cash Prizes Up to $599: You can cash all prizes of $599 or less at participating Lottery Retailers.
  • Claimant Information: Ensure that you read all instructions carefully before completing the claim form.
  • Attach the Ticket: Always attach the original ticket to the form, ensuring your legal name, signature, and address are visible.
  • Signature Requirement: Sign the claim form with ink; only one signature is permitted, and it must match the signature on the ticket.
  • Processing Time: Once your claim is received and verified, processing may take approximately 8 weeks.
  • Tax Information: Be aware that federal taxes may be withheld from your winnings, depending on your citizenship status.
  • Multiple Claims: If you have more than one ticket, attach a separate claim form for each ticket.
  • Privacy Notice: Your personal information will be used solely for validating and processing your claim, and certain details may be subject to public disclosure.

By following these guidelines, you can ensure a smoother experience when claiming your prize from the California Lottery.