Last updated: 7/11/2012
Identification Form For Unclaimed Funds (Individual)
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Description
RESET FORM UNITED STATES BANKRUPTCY COURT FOR THE SOUTHERN DISTRICT OF IOWA 110 E. Court Avenue, Ste 300 Des Moines, Iowa 50309 www.iasb.uscourts.gov In the Matter of: Case No. IDENTIFICATION FORM FOR UNCLAIMED FUNDS INDIVIDUAL I, _________________________________, hereby state that I am a _________________ in the above-named case and request payment of my unclaimed funds. Address: Social Security Number: XXX-XX _________ Signature: Name: Address: Telephone: ATTACH A PHOTOCOPY OF A GOVERNMENT ISSUED PHOTO-IDENTIFICATION CARD (i.e. Driver's License) J:\Web\Forms\PDF Files\ID Ind Unclaimed Funds 7/13/10 American LegalNet, Inc. www.FormsWorkFlow.com