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Get NE Lottery 10-029-93 2019

Back of ticket(s). Sign your name on back of ticket(s). Complete all required items on this form. Sign and date this form. Mail this form (certified mail recommended) to: Mailing Address City Prize Claims, Nebraska Lottery P.O. Box 95145, Lincoln, NE 68509-5145 or redeem at the nearest Lottery Claim Center listed on the reverse side of form. Disclosure of social security number is required for withholding of federal and state income tax and to perform any offsets authorized by the State L.

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