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Unclaimed Funds

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24 views5 pages

Unclaimed Funds

Uploaded by

Solana Art
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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To: Applicant for Withdrawal of Unclaimed Funds

Subject: Procedure for Applying for Payment of Unclaimed Funds

The following procedures must be followed in order to apply for the payment of unclaimed
funds:

- Prepare an AApplication for Order Directing Payment of Unclaimed Funds@ and make
sure to sign it. (example attached)

- Complete the attached AAffidavit of Creditor@ form and have it notarized. Every
application must include an AAffidavit of Creditor.@ The notarization must be visible
and the notary must personally sign the document.

- If creditor is an individual, include a photocopy of your driver=s license or some other


form of personal identification with photograph.

- If creditor is a corporation, partnership, or other entity, include supporting


documentation that the applicant is authorized to claim money on behalf of the
corporation, partnership, or other entity.

- Mail or deliver all of the original documents to the Court Clerk=s office at the following
address:

United States Bankruptcy Court


Western District of Oklahoma
Attn: Tony Sossamon
215 Dean A. McGee Avenue
Oklahoma City, OK 73102

- Mail or deliver a copy of the completed AApplication for Order Directing Payment of
Unclaimed Funds@ to the U.S. Attorney at the following address:

United States Attorney


Western District of Oklahoma
210 West Park Avenue, Suite 400
Oklahoma City, OK 73102

After submission of the application to the Clerk=s office, processing the request will require from
two to six weeks. Upon completion, a check will be mailed to the applicant.

If you have questions about filling out and submitting the required documents or any other
questions about the procedures, please contact Tony Sossamon at (405) 609-5755.
LOCAL FORM 5

UNITED STATES BANKRUPTCY COURT


FOR THE WESTERN DISTRICT OF OKLAHOMA

IN RE: )
) Case No. ___-______-___
Debtor(s) name, )
) Chapter _____
Debtor(s). )

APPLICATION FOR ORDER DIRECTING PAYMENT


OF UNCLAIMED FUNDS TO CREDITOR/CLAIMANT

A dividend/refund check in the above-named case issued to the payee, _______________

__________________________________________, in the amount of $________, was not

cashed by said payee, and, pursuant to 11 U.S.C. § 347(a) of the Bankruptcy Code, the trustee

paid this unclaimed money to the Registry of the Clerk, United States Bankruptcy Court.

The undersigned creditor/claimant has made sufficient inquiry and has no knowledge that

this claim has been previously paid, that any other application for this claim is currently pending

before this Court, or that any other party other than this Applicant is entitled to submit an

application for this claim.

Applicant has provided notice to the U.S. Attorney pursuant to 28 U.S.C. § 2042.

THEREFORE, Application is hereby made for the Clerk, U.S. Bankruptcy Court, to pay

this unclaimed money to (Name and address of payee (creditor/claimant) .

_______________________________ ____________________________________
Date Signature of creditor/claimant
_______________________________ ___________________________________
Tax ID or last 4 numbers of SSN Print name of creditor/claimant

___________________________________
Address of creditor/claimant

I hereby certify by my signature above, that a copy of this Application was mailed on the
_____ day of ______________, 20___, to the United States Attorney, 210 Park Avenue, Suite
400, Oklahoma City, OK 73102 and to the following:

Panel Trustee
Assistant United States Trustee
Debtor
Debtor’s Attorney, if any
Original Claimant, if different
Original Claimant’s Attorney, if discernible

___________________________________
Signature of creditor/claimant
UNITED STATES BANKRUPTCY COURT
FOR THE WESTERN DISTRICT OF OKLAHOMA

IN RE: )
) Case No. ___-______-___
Debtor(s) name, )
) Chapter _____
Debtor(s). )

AFFIDAVIT OF CREDITOR/CLAIMANT

State of ______________________ ) Tax ID or Last 4 numbers of SSN:


: ss ___________________________
County of ____________________ )

I. ___________________________________, the undersigned creditor/claimant in the

above referenced case, being first duly sworn upon oath, state as follows:

1. (Name and Address) has been

granted a power of attorney by me to submit Application for Payment from Unclaimed Funds

seeking payment of claim number ________, in the amount of $______________, due and

owing to me as a creditor/claimant in the above-referenced bankruptcy case.

2. My name, position with the company (if applicable), address and telephone

number are as follows:

___________________________________________

___________________________________________

___________________________________________

3. If other than individual: Substantiate creditor’s right to claim, including but not

limited to, documents relating to sale of company, i.e., purchase agreements and/or stipulation by

prior and new owner as to right of ownership of funds. Attach certified copies of all necessary

documentation.
4. I (or the entity I represent) have neither previously received remittance for the

claim nor have contracted with any other party other than the person named in Item 1 above to

recover these funds.

I certify that the foregoing statements are true and correct to the best of my knowledge

and belief.

DATED: _______________________

__________________________________
Creditor/Claimant Signature

Subscribed and sworn to before me this ______ day of _________________, 20___.

My commission expires: __________________________________


______________________ Notary Public

(Seal)

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