New York Lotto 6/59 Order Form

We accept credit cards and Online Checks for payment of your order. If using Online Checks, please fill in complete bank information. Supply us with your check number then void the check. We will draft a check using that check number and submit it to our bank for regular bank processing.

Choose how you want your numbers selected:

I want to use the IMI Computerized Lotto Picker

I want to choose my own numbers

How many games (tickets) do you wish to play?

For how many draws do you want to play your numbers?

Please select how you want the jackpot paid

If choosing your own numbers, enter your selected numbers between 1 and 59 for each game you wish to play. There is room for up to 20 games. Enter them like this: (01-09-15-38-40-59)

Warning: All numbers must be entered in ascending order!
Low to high! All numbers must be entered as two digits
(see above example).

Number of Games	Your Numbers	Price Per Game
1		$1.00
2		$1.00
3		$1.00
4		$1.00
5		$1.00
6		$1.00
7		$1.00
8		$1.00
9		$1.00
10		$1.00
11		$1.00
12		$1.00
13		$1.00
14		$1.00
15		$1.00
16		$1.00
17		$1.00
18		$1.00
19		$1.00
20		$1.00

Total Amount Due (Number of Games X Numner of Draws X $1.00, Min. $20.00)

Please provide the following contact information:

Name

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Home Phone

FAX

E-mail

URL

If paying by credit card, please provide the following payment information:

I wish to pay by:

Credit card

Cardholder name

Card number

Expiration date

If paying by Online Check, please supply us with the following check information:

Name on check
Address on check
City on check
State on check
Zip Code on check

Please supply us the bank branch # (usually a number that looks like this 16-66/1234 that is generally located on the top right hand side of check near the check number)

Bank Branch Number

Please supply us the group of numbers at the bottom of the check. They consist of the 9 digit Routing Number, your Bank Account Number, and your Check Number.

Bank Routing Number
Bank Account Number
Check Number
Bank Name
Bank City, State & Zip

I authorize International Marketing, Inc. to draft a check or debit my credit card for
to cover the cost of my order for the New York Lotto 6/59

Deadline for online orders: Wednesday and Friday 2:00 p.m. (ET)
For subscriptions of 10 draws or more: 10:00a.m.

Go to a different Lotto Order Form

Florida "New Fantasy 5" 5/36 Florida Lotto 6/53 German Lotto 6/49
California Lotto 5/47+1/27 Illinois Lotto 6/52 "Big Game" 5/50 +1/36
Ohio Lotto 6/49 "Powerball" 5/49 +1/42 Pennsylvania 6/69
West Virgina Lotto 6/25 Florida "Mega Money"

More Information?
E-Mail us!
sales@megawin.com

International Marketing Index
Wolfenborn 14
D-65329 Hohenstein

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