MEGA MILLIONS® SUBSCRIPTION APPLICATION
How to Subscribe and Mail In:
• Complete the application. Additional copies may be obtained from mdlottery.com/subscriptions. • Complete this application and mail it along with a check or money order payable to the Maryland Lottery to: The Mega Millions® Game 1800 Washington Blvd. Suite 300 Baltimore, MD 21230 • Holiday Gift Subscriptions must be received by December 10th in order to be processed by December 24th. Please allow a minimum of 4-6 weeks for the processing of all other applications. Note: If fewer than 6 valid numbers are selected in any game, the Lottery will assign, at random, additional number(s) when processing the application. Once your numbers have been selected or randomly assigned, they can not be changed or cancelled during the life of the subscription. No refunds will be given for any reason. Mega Millions proceeds benefit the Maryland Stadium Authority up to the dollar amount allocated by the Legislature.
1
Complete The Application.
If ordering the Mega Millions Subscription for yourself: Write your name and address in the upper section only.
If you are giving the Mega Millions Subscription as a gift and would like the Lottery to mail it: Write recipient’s name and address in the upper section and only your name in the “If Gift, Fill In From Whom” section. If you’re giving the Mega Millions Subscription as a gift but would like to personally present it: Write recipient’s name and address in the upper section and your name and address in the “If Gift, Fill In From Whom” section. Applicant must be at least 18 years of age and have a Maryland address.
Mega Millions Subscriptions are available in 26, 52 or 104-drawings plans. Each subscription allows you to play either $1 or $2 per drawing. Mark the plan of your choice by simply placing an X over the appropriate box. For example, if you want to play 2 $104 $208 games for 52 drawings, 52 DRAWINGS 104 DRAWINGS you would mark the box PLAN PLAN as shown. Subscriptions are not valid until the effective date listed on applicant’s Subscription Membership Card. Holiday Gift Subscriptions must be received by December 10th in order to be processed by December 24th. Please allow a minimum of 4-6 weeks for the processing of your subscription.
2
Pick A Plan.
Select 5 numbers from 1 to 56 and then select one Mega Ball number from 1 to 46. Or, if you prefer, have your numbers randomly selected for you by checking the appropriate box on the application. You can play up to 2 different sets of numbers on each Mega Millions Subscription form. See example below.
3
Pick Your Numbers.
09 2 7 3 6 1 8 3 9 2 9 1 7 2 3 4 1 06 3 0 2 1
NAME TO APPEAR ON SUBSCRIPTION:
FIRST NAME MIDDLE INITIAL STREET ADDRESS
AGENT NUMBER
LAST NAME
SOCIAL SECURITY NUMBER OR I.D. NUMBER
ROUTE, BOX OR APARTMENT NUMBER
AREA CODE
TELEPHONE NUMBER
CITY
COUNTY
MD
STATE
ZIP
EMAIL ADDRESS
IF GIFT, FILL IN FROM WHOM:
DO NOT SEND CASH CHECK ONE FIRST NAME LAST NAME AMOUNT ENCLOSED CHECK MONEY ORDER YOUR STREET ADDRESS ROUTE, BOX OR APARTMENT NUMBER
CITY
STATE
ZIP
NOTICE: For winnings over $600: a) the Maryland State Lottery Agency (Lottery) is required by the IRS and the Comptroller of Maryland to comply with certain requirements related to gambling winnings, so b) disclosure of your Social Security Number (SSN) is mandatory and c) the Lottery will use your SSN to comply with the Annotated Code of Maryland, Family Law Article, Section 10-113.1 and Criminal Procedure Article, Section 11-618. These sections of Maryland law provide for the interception of Lottery prizes won by any person who has outstanding amounts due for child support arrearage, as certified by the Child Support Enforcement Administration, or anyone who has an outstanding restitution obligation, as certified by the Central Collection Unit of the Department of Budget and Management. Winnings in excess of $600 cannot be paid without your SSN, so the Lottery will contact you for proof of your SSN. You have the right to inspect, amend or correct personal records, although your subscription numbers cannot be changed. Your personal information is not available to the public without your consent. The Lottery does not make your personal information available to or transfer it to any other entity except as certain contractors working with the Lottery may need the information to perform their services to the Lottery and except as the Lottery may be required by law to disclose it.
The information provided on this application is accurate and correct.
SIGNATURE DATE
DO NOT INCLUDE MY NAME ON OTHER MAILING LISTS.
2 DRAWINGS PER WEEK (Tuesday & Friday) 26 DRAWINGS
(13 Weeks)
RANDOMLY SELECT MY NUMBERS.
Write your numbers. Do not fill in if using Randomly Select. Mega Ball
52 DRAWINGS
(26 Weeks)
104 DRAWINGS
(52 Weeks)
$1 PER DRAW
26 DRAWINGS PLAN
$26
52 DRAWINGS PLAN
$52
104 DRAWINGS PLAN
$104
A
$2 PER DRAW
26 DRAWINGS PLAN
$52
52 DRAWINGS PLAN
$104
104 DRAWINGS PLAN
$208
B
(Rev. 6/05)
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Mega Millions Information Keep this form for your records
• With a subscription to Mega Millions, you do not need to check your numbers because the Lottery will do it for you. If you win more than $10, a check will automatically be sent to you within 2-3 weeks. If you win $10 or less, the Lottery will send one consolidated check at the expiration of your subscription. • There are a variety of subscription plans available for 26, 52, or 104 drawings, playing either $1 or $2 per drawing. Select five numbers from 1 to 56 and select one Mega Ball number from 1 to 46. You have the option to choose your own numbers or to have the Lottery randomly select your numbers for the duration of your subscription. • Mega Millions drawings are held twice a week on Tuesday and Friday evenings. • Mega Millions jackpots start at $12 Million and keep getting bigger each time the jackpot has not been hit. It’s easy! Complete this application form by selecting your plan and numbers, and return it in an envelope along with a check or money order payable to the Maryland State Lottery. Mail completed form and payment to:
The Mega Millions Game 1800 Washington Blvd. Suite 330 Baltimore, MD. 21230 Questions? 410-230-8730
Compulsive gambling is a treatable illness. For more information on compulsive gambling, call the Compulsive Gambling Center in Baltimore at 410-332-1111. Outside of the Baltimore Metro area call 1-800-Lost Bet. Or call 1-800-Gambling.
Applicant must be at least 18 years of age and have a Maryland address. A subscription is not valid until the effective date listed on the applicant’s subscription membership card. This subscription membership card is sent by the Maryland Lottery after the application and payment have been received.
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