Showcase Jackpots Delivery Request

REQUEST PROCESS

1. The Validation Number from the Jackpot Receipt Voucher should already appear in the Delivery Request Form (this form) below. Ensure it is correct.
2. The win details will transfer to the completed form so long as the Validation Number is the same as the previously completed Win Details Form.
3. Complete this form to arrange the delivery of the Prize Package.
4. A digital copy of the completed form saved as a Delivery Request Receipt will be emailed to the Winner.
5. Keep a copy of the Delivery Request Receipt to show the delivery person.

ACKNOWLEDGEMENTS

By completing this form you acknowledge the following:

• You are requesting Onyx Gaming (owner of Showcase Jackpots) to arrange delivery.
• All personal details you provide will only be used and stored to fulfill the delivery of the Prize Package.
• The address provided in the form will be the address the delivery will be made to.
• You or the alternative contact person provided in the form will be at the address on the agreed upon time and date.
• You understand and agree to the terms and conditions of the delivery request.
• Onyx Gaming will be in touch within 5 business days to arrange delivery.
• Dates and times of delivery will depend on location.

DELIVERY REQUEST FORM

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Validation *

Is the delivery address the same as the home address that was previously provided?

D Address *

• Same address
• Different address

Address *

Address Line 1

City

State / Province / Region

Postal Code

AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountry

Only complete if delivery address is different to home address.

Notes Contact D

Does the Winner have a contact person they wish to assist in receiving the prize package?

Alternative *

• No
• Yes

Alternative Contact *

First

Last

Only complete if another person will be assisting to receive delivery of prize package.

Notes

By signing below, the winner acknowledges:

• They are requesting Onyx Gaming to arrange delivery.
• All Winner's details provided are correct.
• The address provided will be the address the delivery will be made to.
• They will be at the address on the agreed upon time and date.
• They understand and agree to the terms and conditions of the delivery request.
• Onyx Gaming will be in touch within 5 business days to arrange delivery.

Winner Signature *

Clear Signature

Register Request