| |
Salutation
|
First Name
|
Initial
|
Last Name
|
|
| |
Address
|
Apartment/Suite
|
|
| |
City
|
State
| AL |
| AK |
| AZ |
| AR |
| CA |
| CO |
| CT |
| DE |
| DC |
| FL |
| GA |
| HI |
| ID |
| IL |
| IN |
| IA |
| KS |
| KY |
| LA |
| ME |
| MD |
| MA |
| MI |
| MN |
| MS |
| MO |
| MT |
| NE |
| NV |
| NH |
| NJ |
| NM |
| NY |
| NC |
| ND |
| OH |
| OK |
| OR |
| PA |
| RI |
| SC |
| SD |
| TN |
| TX |
| UT |
| VT |
| VA |
| WA |
| WV |
| WI |
| WY |
| |
|
|
ZIP Code
|
County
| Adair |
| Andrew |
| Atchison |
| Audrain |
| Barry |
| Barton |
| Bates |
| Benton |
| Bollinger |
| Boone |
| Buchanan |
| Butler |
| Caldwell |
| Callaway |
| Camden |
| Cape Girardeau |
| Carroll |
| Carter |
| Cass |
| Cedar |
| Chariton |
| Christian |
| Clark |
| Clay |
| Clinton |
| Cole |
| Cooper |
| Crawford |
| Dade |
| Dallas |
| Daviess |
| DeKalb |
| Dent |
| Douglas |
| Dunklin |
| Franklin |
| Gasconade |
| Gentry |
| Greene |
| Grundy |
| Harrison |
| Henry |
| Hickory |
| Holt |
| Howard |
| Howell |
| Iron |
| Jackson |
| Jasper |
| Jefferson |
| Johnson |
| Knox |
| Laclede |
| Lafayette |
| Lawrence |
| Lewis |
| Lincoln |
| Linn |
| Livingston |
| Macon |
| Madison |
| Maries |
| Marion |
| McDonald |
| Mercer |
| Miller |
| Mississippi |
| Moniteau |
| Monroe |
| Montgomery |
| Morgan |
| New Madrid |
| Newton |
| Nodaway |
| Oregon |
| Osage |
| Ozark |
| Pemiscot |
| Perry |
| Pettis |
| Phelps |
| Pike |
| Platte |
| Polk |
| Pulaski |
| Putnam |
| Ralls |
| Randolph |
| Ray |
| Reynolds |
| Ripley |
| Saline |
| Schuyler |
| Scotland |
| Scott |
| Shannon |
| Shelby |
| St. Charles |
| St. Clair |
| St. Francois |
| St. Louis City |
| St. Louis County |
| Ste. Genevieve |
| Stoddard |
| Stone |
| Sullivan |
| Taney |
| Texas |
| Vernon |
| Warren |
| Washington |
| Wayne |
| Webster |
| Worth |
| Wright |
|
|
|
Email Address
|
| |
Home Telephone Number
|
Work Telephone Number
|
|
|
|
Choose Company Name:
| Certamen Games, LLC |
| DK Crown Holdings Inc. |
| FanDuel, Inc. |
| FastDraft, LLC |
| FFPC, LLC |
| OwnersBox 3.0 Corporation |
| RealTime Fantasy Sports, Inc. |
| SidePrize LLC |
| Sleeper DFS LLC |
| SportsHub Regulatory, LLC |
| TokenTourney LLC |
| Two Nine Sports, Inc. |
| Underdog Sports, LLC |
| Yahoo Fantasy Sports LLC |
|
|
Incident Date
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| 10 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| 11 | 8 | 9 | 10 | 11 | 12 | 13 | 14 |
| 12 | 15 | 16 | 17 | 18 | 19 | 20 | 21 |
| 13 | 22 | 23 | 24 | 25 | 26 | 27 | 28 |
| 14 | 29 | 30 | 31 | 1 | 2 | 3 | 4 |
| 15 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
|
|
| Jan | Feb | Mar | Apr |
| May | Jun | Jul | Aug |
| Sep | Oct | Nov | Dec |
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Incident Time
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| 10 | 1 | 2 | 3 | 4 | 5 | 6 | 7 |
| 11 | 8 | 9 | 10 | 11 | 12 | 13 | 14 |
| 12 | 15 | 16 | 17 | 18 | 19 | 20 | 21 |
| 13 | 22 | 23 | 24 | 25 | 26 | 27 | 28 |
| 14 | 29 | 30 | 31 | 1 | 2 | 3 | 4 |
| 15 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
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