House lottery in Upper Austria

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Please complete all fields marked * in order to register.

Personal details
Given name:*
Surname:*
Date of birth:*	DD 12345678910111213141516171819202122232425262728293031 MM 123456789101112 YYYY 19951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910
Street/Number:*
Postcode/Town:*
Country:*
Telephone:*
Email:*
Tickets:
Number of tickets:
Ticket price:
Bank details in case the payment has to be transferred back to you
Please furnish your bank details in case the payment has to be transferred back to you (e.g. lottery is cancelled). For transfers abroad please state BIC and IBAN,
Account holder:
Account number:
Bank:
Sort code:
IBAN:
BIC:
Terms of participation:
Yes, I have read and accept the terms for participation and the standard terms. *
Security question to prevent spam
Enter the combination of numbers in the field alongside*
Registration and the drawing of tickets involve no costs or obligations whatsoever. Only tickets that have been paid for in full take part in the lottery. It goes without saying that we shall not communicate your personal details to third parties. .