GROUP BUYING AGREEMENT ................................................................................ We, the undersigned, hereby declare that we are joint owners, in the proportions shown opposite our respective names of the game: ____________________________________ (name of the LOTTO game) LOTTERY tickets for draw number: ___________________________ to be held on _____________________, 19____ _______________________, 19____ _____________________, 19____ _______________________, 19____ _____________________, 19____ _______________________, 19____ bearing the numbers listed bellow Each of the tickets mentioned shall be endorsed as follows: ____________________________________________________________________________ Name of the member of the group "in trust" for all the group members and if one or more tickets should be winners, payment or delivery of any prize shall be made to the person whose name is endorsed on the tickets and for so doing this shall constitute the full and sufficient authority to LOTTO officials, as the case may be. As between themselves only, any prize or prizes shall be shared among the undersigned in the proportions stated below and each of the undersigned acknowledges, in case of death, their respective rights in the said tickets shall pass to their estate. Dated at ___________________, this __________day of __________________ 19____ TICKET INFORMATION ticket numbers __________________ ___________________ _________________ __________________ ___________________ _________________ __________________ ___________________ _________________ __________________ ___________________ _________________ NAMES OF JOINT OWNERS names addresses/phones signatures shares _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ _____________________ ___________________ ______________________ ______ Additional names on reverse check |____|