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Get Tx 55-201 2016

Ber.) A deposit slip is not acceptable. For changes to an existing lottery account, this form and a void check or bank letter may be faxed to the Lottery at 512-344-5039. If you have questions, contact Retailer Services at customer.service@lottery.state.tx.us or 800-375-6886. — SUBMITTING INCORRECT OR INCOMPLETE INFORMATION MAY DELAY PROCESSING. — FOR LOTTERY USE ONLY. DO NOT WRITE IN THE SHADED AREA. o New Retailer o Change of EFT o Other (Comment below.) Check One: Tax Payer ID Number .

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