Membership Promotion Claim Form

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Membership Promotion Claim Form

Congratulations!

Please complete the claim form in order to receive your prize.

Membership Promotion Claim Form

Congratulations on winning a Union Sportsmen's Alliance Giveaway!
1. Please select the Membership giveaway that you won:*
Local Union Information
2. Union Affiliation*
3. Union #*
If you're a member of the international office, please enter "International."
Winner's Contact Information
4. Name*
First Last
5. Birthdate*
Month
Day
Year
6. Please check appropriately (If your prize value is greater than $600, you must provide your Social Security Number in box below)*
See promotion for Actual Retail Value
- My prize is valued greater than $600, I understand a 1099 form will need to be issued to me for tax purposes.
- My prize is valued less than $600.
6a. Social Security No.
7. Phone Number*
8. Email Address*
9. Address*
Street Address Address Line 2 City State Zip
Firearm Shipment Details
Please complete if your package included a firearm. NOTE: Your firearm must be shipped to a licensed Federal Firearm Dealer. Please fill out all of the information below so that we can contact your dealer and coordinate the transfer of your firearm. Please contact dealer before submitting form to make sure they will accept the transfer. Please allow 6-8 weeks for shipping of prize once paperwork is submitted.
FFL Dealer / Gun Shop
FFL Dealer / Gun Shop Contact Name
First Last
FFL Dealer / Gun Shop Phone Number
FFL Dealer / Gun Shop Address
Street Address Address Line 2 City State Zip / Postal Code
Your FFL Dealer’s Federal Firearms License
Max. file size: 256 MB.
*
- I authorize the Union Sportsmen’s Alliance, as well as their successors and affiliates to use my name, photo, image, likeness, verbal quotes, story, or portions thereof, and other good and valuable considerations - or that of my child, if applicable - in any promotional materials, literary and/or commercial purposes in print, imagery, video and online. I understand that no payment is due to me for such usage. By checking this box, I have read and am agreeing to all terms stated above. I certify that the information above is true and correct to the best of my knowledge.
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Comments
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Membership Promotion Claim Form

Membership Promotion Claim Form

Congratulations on winning a Union Sportsmen's Alliance Giveaway!

Local Union Information

Winner's Contact Information

Firearm Shipment Details

Ready to Get Involved?