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Affidavit of Eligibility and Liability Publicity

Affidavit of Eligibility and Liability Publicity
Release Form Without Notary Requirement

Congratulations! You are a potential Winner in this Giveaway. To confirm your eligibility, please complete the following Affidavit of Eligibility and Liability/Publicity Release Form (the "Affidavit and Release"). Please read this document carefully before completing and signing. It must be completed or you will forfeit your prize and an alternate winner will be selected.

Once we receive your Affidavit and Release and verify all eligibility qualifications have been met, you will receive access to the prize.

Being duly sworn, I hereby represent that I am a U.S. citizen and a resident of WA state. I am submitting this affidavit with the understanding that it will be relied upon to determine my eligibility in the Giveaway.

I affirm and represent that I have complied with all the Official Rules and regulations of the Giveaway and that I have committed no fraud or deception in entering the giveaway or in claiming any prize. I further represent that I am not an employee of the Sponsor or of any other entity stated in the official rules whose employees are not eligible to enter the Giveaway or a member of the family of any employee.

I understand that I am entitled to receive only the announced prize and that prizes are non-transferable and no substitutions will be made except at the sole discretion of the Sponsor or as provided in the Official Rules.

I hereby give my consent to the Sponsor for the use of my name, photograph, without further obligation to me, in any advertising and promotional materials relating to the Giveaway and similar promotions which may be offered by the Sponsor in any media, including on the Internet, without territorial, time, use or other limitation.

I understand and acknowledge and hereby, for myself, my heirs, executers and administrators, do waive and release any and all rights, claims and causes of action whatsoever l may have against the Sponsor for any matter, cause or things whatsoever arising out of my participation in this Giveaway and my acceptance and utilization of the prize that I have won in the Giveaway.

I also acknowledge that I am solely responsible for all federal, state and local taxes due as a winner of this Giveaway. I recognize that I may wish to seek independent counsel to determine the full extent of my tax liability under state federal laws and regulations. I acknowledge and agree that I am responsible for all other expenses that may become due because of my winning the prize.

I hereby agree that Sponsor have neither made nor are in any manner responsible or liable for any warranty, representation, or guarantee, expressed or implied, in fact or in law, relative to any prize, including but not limited to its quality, service quality, fitness for a particular purpose or mechanical condition.

I agree to return immediately upon demand to the Sponsor any prize or the value of said prize that I have already received that has been or may be awarded to me if any statement made by me in this affidavit is false.

I warrant and represent that I am at least twenty one years of age.

I declare that all information I submit in this affidavit is true and correct. I attest that I have read, or have had read to me, and understand all the foregoing provisions of this affidavit, prior to its execution, and agree to bound by them.

All information below is kept on a secure site. Your information will not be shared with anyone outside of what is outlined in this agreement and release form.

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November 3, 2024 9:12 pm PST

Affidavit of Eligibility and Liability Publicity Uploaded by scott smith - scottsm8@gmail.com IP 98.203.141.236