Free Identification Form for Unclaimed Funds - Individual - Iowa

CLEAR FORM
UNITED STATES BANKRUPTCY COURT FOR THE SOUTHERN DISTRICT OF IOWA
P.O. Box 9264 Des Moines, Iowa 50306-9264 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:

PRINT
ATTACH A PHOTOCOPY OF A GOVERNMENT ISSUED PHOTO-IDENTIFICATION CARD (i.e. Driver's License)

J:\Web\Forms\PDF Files\ID Ind Unclaimed Funds