The statement must contain the following information for each instant lottery:1° the number of cards on sale;
2° the number of cards sold;
3° the selling price of each card;
4° the gross revenues from the sale of instant lottery cards;
5° the total value of prizes awarded;
6° the actual cost of each prize awarded, as well as supporting vouchers at the board’s request;
7° the total value of the prizes claimed;
8° the administration expenses;
9° the profit or loss;
10° the name and address of each winner of a prize valued at $2,000 or more, at the board’s request;
11° an attestation that all prizes offered were awarded or the reasons why they were not awarded.