Mail In Entry Form ALL FIELDS REQUIRED FOR VALID ENTRY! NAME: _______________________________________________________________________ ADDRESS: ____________________________________________________________________ ____________________________________________________________________ PHONE NUMBER: ______________________________________________________________ EMAIL ADDRESS OR ALTERNATE PHONE NUMBER: ___________________________________ ⎕ I have read and agree to terms and conditions: ____________________________________________________________________________ Signature Date Number of entries (maximum 10) ___________ X $100 = $_________________ AMOUNT ENCLOSED Print form, sign and date, and enclose your check made out to EBLEN CHARITIES. Mail to: Eblen Charities 50 Westgate Parkway Asheville NC 28806 Attn: Raffle If you prefer to pay by credit card: Visit our web site www.eblencharities.org Or visit www.mustangsforhunger.com (works best with mobile devices) Or call Eblen at (828) 255-3066 between 9:00 and 4:00 Eastern time, Mon-Fri Terms & Conditions Prizes ROUSH RS V6 300 HP automatic loaded 2015 Mustang. Jack Roush, NASCAR racing legend of Roush Racing, will sign the car for the winner of this automobile. This car is provided by Tindol Ford of Gastonia, North Carolina. V6 300 HP 2015 Mustang fully equipped, power seats, power windows, tilt, cruise, CD player, automatic transmission. This car is provided by Asheville Ford of Asheville, North Carolina. Eligibility and Ticket Purchases Each raffle entry purchase of $100 entitles the purchaser to two tickets, i.e., a single chance to win in each of two separate drawings. One ticket will be entered into a drawing for the 2015 Roush Mustang. The other ticket will be entered into a drawing for the 2015 Mustang V6. Entrants may not request that both tickets be entered into a drawing for only one of the cars. A minimum of 1,200 raffle entries must be sold in order to conduct the Eblen Charities Food For Thought 2015 Mustang Raffle. A maximum of 1,822 raffle entries will be sold. Odds of winning are 1 in 911 or better, for each raffle entry comprised of two tickets. For each individual ticket, odds of winning are 1 in 1822, or better. Entrants can split a raffle entry purchase with another person; however the name on both tickets will be issued in the name of the raffle entry purchaser. Eblen Charities is not responsible for determining which ticket holder is the winner of a shared entry. Raffle entry purchaser must be an individual 18 years or older at the time of raffle entry purchase. Eblen Charities, Inc. employees and board members and their immediate family members are not eligible to participate in the raffle. Immediate family is defined as a person related by blood or marriage within one degree of familial relationship (including in-laws and step family) and/or living in the same household as Eblen employees or board members (including domestic partners). Each entrant may purchase a maximum of 10 raffle entries. Raffle entry purchases are NOT refundable at the request of the purchaser for any reason. Raffle ticket purchases are NOT tax deductible charitable donations, according to IRS rules. All federal, state, and local laws apply. Raffle entries may be purchased in one of three ways: 1 2 3 Eblen’s web site www.eblencharities.org The mustangsforhunger.com web site. Works best for mobile devices. U.S. Mail. To enter by mail, send check or money order for $100 per entry, payable to Eblen Charities, 50 Westgate Parkway, Asheville NC 28806. Mail-in entrants will receive an entry form that must be completed and returned to Eblen before entry is official. A downloadable mail-in entry form can also be found on Eblen’s web site. NSF checks will not be considered a valid raffle entry. Raffle entry fees received by Eblen after the drawing date will be refunded to entrant. By entering the raffle, the entry purchaser acknowledges that he or she is aware of, and agrees to abide by, the official rules and regulations of the raffle. Prizes and Alternate Prizes Each raffle entry is comprised of two tickets. Each ticket will be entered into a separate drawing for one of the two prize vehicles. Eblen Charities will also pay the grossed up Withholding Tax on Raffle Prizes of 33.33% of the value of the prize for each of the prize winners. Eblen Charites will report all winner names’, tax ID numbers and prize value to the IRS as required by law. Eblen Charities will also pay the Withholding Tax on Raffle Prizes directly to the IRS on behalf of the winners of the automobiles. A prize winner must provide his/her social security number before taking possession of a prize in order to insure compliance with all relevant tax laws. Winners will be responsible for payment of tag fees and all state taxes and fees. The winners are responsible for payment of any non-standard options chosen by the winner and negotiated with the dealership. All costs of car ownership, including but not limited to insurance, are the sole responsibility of the winners. The automobile dealerships providing the prize cars is selected solely by Eblen Charities The color and other options for the prize automobiles depend on availability at the participating dealership. All prize cars will be titled at the dealership. Winner of the V6 300 HP 2015 Mustang will need to make arrangements to pick up their prize in Asheville NC. Winner of the ROUSH Mustang will need to make arrangements to pick up their prize in Gastonia NC. There is NO a cash award offered in lieu of the prize automobiles, except in the special circumstances cited below. Grand Prize Award in Event of Non-Sellout of Tickets: In the unlikely event that 1,200 raffle entries are not sold by December 10, 2015, Eblen Charities reserves the right in its absolute discretion to substitute cash prizes in lieu of the two cars. Each of the two tickets that comprise one raffle entry will be entered into a separate drawing for a cash prize of $10,000. Thus, two $10,000 cash prizes will be awarded. Eblen Charities will not pay the Withholding Tax for cash prizes. Eblen will comply with all federal and state tax laws regarding the awarding of cash prizes. Selecting a Winner The tentative date of the drawing is September 30, 2015. However, if tickets sell out before this date an earlier drawing date will be announced. Once the drawing date has been determined, the time and location of the drawing will be announced. A random drawing for the winners will take place in Asheville, North Carolina. Full details regarding drawing procedures will be published along with announcement of drawing date. Raffle entrants may be present for the drawing, but do not need to be present to win. Prize winners will be required to verify their identification and eligibility to the satisfaction of Eblen Charities, Inc. Winners may be required to sign an affidavit of eligibility. Eblen Charities will engage a North Carolina Certified Public Accountant to provide attest services to verify the fairness and impartiality of the winning ticket drawings. The CPA’s attest report will be available to the public after completed. Requests for the report should be sent to Eblen Charites at 50 Westgate Parkway, Asheville NC 28806. Notifying Winners The winners of the drawing will be notified by e-mail, U.S. mail and telephone no later than 7 days after the drawing. It is the responsibility of raffle entrants to provide a valid, deliverable mailing address and/or email address to Eblen Charities at the time of purchase. Raffle winners’ names will also be published on the Eblen web site until the prizes have been claimed, or for up to 30 days after the drawing, whichever comes first. Winners have 30 days from notification date to claim their prize. If winner is unable to be contacted or located after 30 days from the notification date, the prize or its cash equivalent will be deemed to have been donated to Eblen Charities to be used for their charitable purposes. Winners consent to the use of his or her name, photographs and/or likeness for advertising and publicity purposes without additional compensation. The winners’ names may be disclosed to and used by the news media and published in area newspapers or other media including television, radio, web and print. Other Important Items Eblen Charities reserves the right to accept or reject any raffle entry and/or modify or extend prize drawing deadlines at their sole discretion. Eblen Charities can, at any time it chooses, without recourse, decide to terminate or modify the raffle if the integrity of the raffle appears to be compromised. If the raffle is cancelled, all monies paid for raffle tickets will be returned to entrants. Eblen Charities will have no further obligations to raffle entrants except for a full refund of the raffle entry fee.
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