By my signature hereto, I indemnify the Colorado Lottery for any loss which may result if any of the foregoing information is not true and accurate. I understand that the Colorado Lottery is a state agency and therefore my name, city of residence and prize amount is public record and may be made available for public information. Under penalty of perjury, I declare that to the best of my …
https://assets.lotteryusa.com/claim-forms/colorado-lottery-prize-claim-form.pdf

