Transcription of Unclaimed Property Claim Form & Checklist Comptroller of …
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Unclaimed Property Claim Form & Checklist Comptroller of …
COT/ST 912 Property Claim Form & Checklist Comptroller of MarylandCompliance DivisionUnclaimed Property Unit, 301 West Preston Street Room 310 Baltimore, Maryland 21201-2385410-767-1700, or 1-800-782-7383 See attachment for instructionsPlease be sure to attach copies of all necessary A - Claimant Information - Please print clearlyName of Claimant(s) Social Security or FEIN Number Daytime telephone numberAddress of Claimant(s) city , state, zip codeRelationship to original owner Email AddressPart B - Information on Property claimed - OFFICE USE ONLYO riginal owner name Social Security or FEIN NumberType of Property Holder name Amount of PropertyPart C - Provide the following documentsCopy of your driver s license or other ID (Required)Copy of Social Security Card or other documentation containing social security number (Required)Bank documents ( passbook, bank statement, cancelled check) Proof of affiliation with: Letters of Administration Small Estate Papers True Test Copy of Court Order Copy of Death Certificate(s) for: Other:Part D AffidavitUnder penalties of perjury, I (we) hereby certify that the for
Comptroller of Maryland Compliance Division Unclaimed Property Unit, 301 West Preston Street Room 310 Baltimore, Maryland 21201-2385 410-767-1700, or 1-800-782-7383 ... City, state, zip code Relationship to original owner Email Address Part B - Information on Property claimed - OFFICE USE ONLY ...
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