AMOE Mail-In Request Form

Instructions

• No purchase is necessary to enter or win. Use this form to request free Sweeps Coins (SC).
• Complete every field below in ink (or type, then print). Sign and date where indicated.
• Mail one (1) completed form per stamped, hand-addressed #10 envelope to the address at the bottom.
• Postage is the sender's responsibility. SC will be credited to the verified account listed below.

1. Your Information

Full legal name (exactly as it appears on your OnPoint account)

OnPoint user ID

Account email address

Residential street address (no P.O. boxes)

City

State

ZIP code

2. Your Request

I request free Sweeps Coins (SC) from OnPoint Casino.

I certify that I am at least 18 years of age (or the age of majority in my state), that the information provided above is true and accurate, and that I am the registered holder of the OnPoint account listed above.

Signature

Date

Mail this completed form to

OnPoint Administration LLC
Attn: AMOE / Sweeps Coins Request
8080 N Central Expy, Suite 1700
Dallas, TX 75206
United States