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 ϻ 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?$2!xxb  SPLIT-THE-POTstaff Hlynosky, Bob Oh+'0|   , 8 D P\dltSPLIT-THE-POTstaffNormalHlynosky, Bob3Microsoft Office Word@<@).@8nڀ@v盞5 ՜.+,0 hp  ϻ H SPLIT-THE-POT Title  !"#$%&()*+,-.01234569Root Entry Fك;Data 1Table!WordDocument.SummaryInformation('DocumentSummaryInformation8/CompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q