ࡱ> 8:7O bjbjyy .eeK8;Okk(nnnqssssss$R!hQnnQQQ^qQqp^]0! 0!!n"nnn=nnnQQQQ!nnnnnnnnn :  SPLIT-THE-POT Date: Game: ________________________________________________________________________ Social Security Number ________________________________________________________________________ Name ________________________________________________________________________ Permanent Address ________________________________________________________________________ City, State, Zip ________________________________________________________________________ Area Code Telephone Number CONGRATULATIONS! You have won approximately $_____________. The exact amount will be determined by the final audit. A check will be mailed to you at the address listed above. Please allow four (4) to six (6) weeks for processing. Per IRS regulations The 91Ԫ must report any winnings of $600.00 or more annually on IRS form W-2G. Payments of $5,000.00 or more require federal income tax withholding on the entire amount at the 24% tax rate. Thank you for participating in Grizzly, Split-The-Pot. Kent Haslam Athletic Director SPLIT-THE POT PAYMENT VOUCHER FOR BUSINESS SERVICES USE ONLY Index Revenue Account Description Activity Code Amount___ Staple Ticket Staple Winning Drawn Here Ticket Here ________________________________ Departmental Approval ________________________________ Date      FILENAME \p \\micaserver00\ica_everyone$\Facilities\Facilities Student\STP and Program Information\STP Winner form.doc  DATE \@ "M/d/yy" 10/26/21 jmh      ; B D Q R T _ ` q s t  KLNOQRTUWXefynh,CJmHnHuhW<<CJmHnHu hf$CJjhf$CJUh oujh ouU hd>*hOfhd5CJ\aJhOfhdCJaJ hd5\hchc5hchc6hch,h&hcCJ aJ hdCJ aJ hchdCJ aJ hd+wx! & o $ G H 3 4   S T ` r s t $d &d N P t    QKMNPQSTVW &d P $a$hdh ouhf$ hf$CJ,1h/ =!"#$% w2 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@6666_HmH nH sH tH @`@ NormalCJ_HaJmH sH tH @@@  Heading 1$$@&a$5\DA D Default Paragraph FontViV  Table Normal :V 44 la (k (No List 2>@2 Title$a$5\44 Header  !4 @4 Footer  !H"H WQ Balloon TextCJOJQJ^JaJN/1N WQBalloon Text CharCJOJQJ^JaJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭VGRU1a$N% ʣꂣKЛjVkUDRKQj/dR*SxMPsʧJ5$4vq^WCʽ D{>̳`3REB=꽻Ut Qy@֐\.X7<:+& 0h @>nƭBVqu ѡ{5kP?O&Cנ Aw0kPo۵(h[5($=CVs]mY2zw`nKDC]j%KXK 'P@$I=Y%C%gx'$!V(ekڤք'Qt!x7xbJ7 o߼W_y|nʒ;Fido/_1z/L?>o_;9:33`=—S,FĔ觑@)R8elmEv|!ո/,Ә%qh|'1:`ij.̳u'k CZ^WcK0'E8S߱sˮdΙ`K}A"NșM1I/AeހQתGF@A~eh-QR9C 5 ~d"9 0exp<^!͸~J7䒜t L䈝c\)Ic8E&]Sf~@Aw?'r3Ȱ&2@7k}̬naWJ}N1XGVh`L%Z`=`VKb*X=z%"sI<&n| .qc:?7/N<Z*`]u-]e|aѸ¾|mH{m3CԚ .ÕnAr)[;-ݑ$$`:Ʊ>NVl%kv:Ns _OuCX=mO4m's߸d|0n;pt2e}:zOrgI( 'B='8\L`"Ǚ 4F+8JI$rՑVLvVxNN";fVYx-,JfV<+k>hP!aLfh:HHX WQXt,:JU{,Z BpB)sֻڙӇiE4(=U\.O. +x"aMB[F7x"ytѫиK-zz>F>75eo5C9Z%c7ܼ%6M2ˊ 9B" N "1(IzZ~>Yr]H+9pd\4n(Kg\V$=]B,lוDA=eX)Ly5ot e㈮bW3gp : j$/g*QjZTa!e9#i5*j5ö fE`514g{7vnO(^ ,j~V9;kvv"adV݊oTAn7jah+y^@ARhW.GMuO "/e5[s󿬅`Z'WfPt~f}kA'0z|>ܙ|Uw{@՘tAm'`4T֠2j ۣhvWwA9 ZNU+Awvhv36V`^PK! ѐ'theme/theme/_rels/themeManager.xml.relsM 0wooӺ&݈Э5 6?$Q ,.aic21h:qm@RN;d`o7gK(M&$R(.1r'JЊT8V"AȻHu}|$b{P8g/]QAsم(#L[PK-![Content_Types].xmlPK-!֧6 0_rels/.relsPK-!kytheme/theme/themeManager.xmlPK-!g theme/theme/theme1.xmlPK-! ѐ' theme/theme/_rels/themeManager.xml.relsPK]   t  8@0(  B S  ?>*??*?ttyy8*urn:schemas-microsoft-com:office:smarttagsCity9*urn:schemas-microsoft-com:office:smarttagsplace KMNPQSTVWgw2KMNPQSTVW3 $nFG :;BCQRT_`qJKMNPQSTVW T_``JKKMNNPQSTVW $Ydf$O:x.W<</E9LWQ@TdOfX{n ouzEyLoo~lkaF&c9P+ON>,?h(oKM@@UnknownG.[x Times New Roman5Symbol3. .[x Arial5. .[`)TahomaC.,.{$ Calibri Light7..{$ CalibriA$BCambria Math"qhpҚGUӚG[g5 5 !24HH3HP?$2!xxb  SPLIT-THE-POTstaff Hlynosky, Bob Oh+'0|   , 8 D P\dltSPLIT-THE-POTstaffNormalHlynosky, Bob3Microsoft Office Word@<@).@8nڀ@v盞5 ՜.+,0 hp  91Ԫ H SPLIT-THE-POT Title  !"#$%&()*+,-.01234569Root Entry Fك;Data 1Table!WordDocument.SummaryInformation('DocumentSummaryInformation8/CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q