Congratulations! You are a potential Winner in this Sweepstakes. To confirm your eligibility, please complete the following Affidavit of Eligibility and Liability/Publicity Release Form (the "Affidavit and Release"). Please read this document carefully before completing and signing. It must be completed or you will forfeit your prize and an alternate winner will be selected.
     Once we receive your Affidavit and Release and verify all eligibility qualifications have been met, you will receive your prize. We are required by law to report to the Internal Revenue Service the fair market value of your prize. You will receive a copy of this documentation and will be responsible for all applicable taxes on the prize.

     Being duly sworn, I hereby represent that I am a U.S. citizen. I am submitting this affidavit with the understanding that it will be relied upon to determine my eligibility in the Promotion.
     I affirm and represent that I have complied with all the Official Rules and regulations of the Sweepstakes and that I have committed no fraud or deception in entering the Sweepstakes or in claiming any prize. I represent that I have obtained my sweepstakes materials through authorized, legitimate channels. I further represent that I am not an employee of the Sponsor or of any other entity stated in the official rules whose employees are not eligible to enter the Sweepstakes or a member of the family of any employee.
     I understand that I am entitled to receive only the announced prize and that prizes are non-transferable and no substitutions will be made except at the sole discretion of the Sponsor or as provided in the Official Rules.
     I hereby give my consent to the Sponsor for the use of my name, address and/or photograph, without further obligation to me, in any advertising and promotional materials relating to the Sweepstakes and similar promotions which may be offered by the Sponsor in any media, including on the Internet, without territorial, time, use or other limitation.

     I understand and acknowledge and hereby, for myself, my heirs, executers and adminisrators, do waive and release any and all rights, claims and causes of action whatsoever l may have against the Sponsor for any matter, cause or things whatsoever arising out of my participation in this Sweepstakes and my acceptance and utilization of the prize that I have won in the Sweepstakes.
     I also acknowledge that I am solely responsible for all federal, state and local taxes due as a winner of this Sweepstakes as well as obtaining and paying for any life, travel, accident, property or other insurance related to the use of the prize. I recognize that I may wish to seek independent counsel to determine the full extent of my tax liability under state federal laws and regulations. I acknowledge and agree that I am responsible for all other expenses that may become due because of my winning the prize.
     I hereby agree that Sponsor have neither made nor are in any manner responsible or liable for any warranty, representation, or guarantee, expressed or implied, in fact or in law, relative to any prize, including but not limited to its quality, merchantability, fitness for a particular purpose or mechanical condition.
     I agree to return immediately upon demand to the Sponsor any prize or the value of said prize that has been or may be awarded to me if any statement made by me in this aftidavit is false.
     I warrant and represent that I am at least eighteen years of age; or, if I am under the age of eighteen, my parent or legal guardian agrees herewith and also has signed below on my behalf.
     I declare that all information I submit in this affidavit is true and correct. I attest that I have read, or have had read to me, and understand all the foregoing provisions of this affidavit, prior to its execution, and agree to bound by them.