FIFA Mega-Jackpot Payment Release Form (Fill And Send Back Immediately)

FIFA
The Power To Surprise
Registered Office: Centrum House
36 Station Road
Egham,Surrey,TW20 9LF
Company No. 04022422
Registered in England and Wales.

Good to hear from you regarding the FIFA World Cup Mega-Jackpot. My names are Dr. James Robert. I am the FIFA World Cup 2014 Brazil Mega-Jackpot Chief Financial officer assigned to winners on the Mobile sweepstakes in your region. In line with the commemorating event marking our FIFA World Cup 2014 Brazil. We rolled out over £20,000.000.00 (Twenty Million Great Britain Pounds) for our annual Anniversary Draws. Your number was selected through a computer ballot system drawn from all the mobile networks in your country as part of the International Promotions Program, which was conducted in Britain, London. This promo is approved by the British Gaming Board and also licensed by the International Association of Gaming Regulators (IAGR). This promo is the 1st of its kind and we intend to sensitize the public. To begin the verification process of your prize, you are required to fill and send back the Payment Release Form below by email.

FORM NO. UK-231-PNG/PORTM
1.FULL NAMES OF BENEFICIARY:
2.RESIDENTIAL ADDRESS:
3.DATE AND PLACE OF BIRTH:
4.MOBILE NUMBER /FAX NUMBERS:
5. SEX:
6. OCCUPATION:
7. MARITAL STATUS:
8. ALTERNATE MOBILE NUMBER:
9. COUNTRY:
10. AMOUNT WON:
11. CLAIMS OPTION:

Indicate which option you prefer to receive your FIFA World Cup 2014 Brazil Mega-Jackpot prize:
(A)On-line Bank Transfer(Hence, you will be responsible for the Encrypt Activation Card charges).
(B) Check Delivery Via Courier ( Hence, You Will Be Responsible For The Courier Delivery Charges).

DECLARATION
I ______________________________ hereby confirm that all the information's given above is to the best of my knowledge true and correct. Any tempering or falsification of the above data rendered in this claims null and avoid.
______________________________

Signature and date.
Thank Congratulations Once Again.
Best Regards,
Dr. James Robert
Contact Centre.
FIFA
The Power To Surprise

FIFA MEGA-JACKPOT UK ™
Registered Office: Centrum House
36 Station Road
Egham,Surrey,TW20 9LF
Company No. 04022422
Registered in England and Wales.
Office Tel: +447937410912 , +44 750 975 9748
Email: fifaworldcup2014@consultant.com

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