Get AK Form 858 2013-2021
Last Day INSTRUCTIONS: Use this form to record information for each pull-tab prize of $50.00 or more. Complete a separate entry on this form for each such prize. The winner MUST complete a Pull-Tab Prize Receipt form. Pull-Tab winners who fail to provide a correct name will not be paid. Attach the winning pull-tabs and associated Pull-Tab Prize Receipts to this Pull-Tab Receipt Log. This page and the attached pull-tab receipts must be kept for a period of three years unless the permittee had g.
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