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    16236108092543_197362

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    Keith Lovely

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    © All Rights Reserved
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    16236108092543_197362

    Uploaded by

    Keith Lovely
    3 views2 pages

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    3 views2 pages

    16236108092543_197362

    Uploaded by

    Keith Lovely

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Office of the General Treasurer

    Seth Magaziner
    State of Rhode Island
    Claim ID: 5358404
    Unclaimed Property Division

    Phone: (401) 462-7676

    Unclaimed Property Claim Form

    KEITH N LOVELY June 13, 2021


    42 LORRAINE AVE
    NORTH SMITHFIELD, RI 02896-7913

    Rhode Island General Treasurer Seth Magaziner is committed to returning unclaimed property in the State's possession to its
    rightful owners. On his behalf, we would like to thank you for your claim. Please complete form in its entirety and print
    legibly.
    Claimant Information
    Name(s): (if different than above) Phone: (501) 771-7950

    Current Address:(if different than above)

    Email Address: [email protected]

    SSN/FEIN: Provided Date of Birth: 04/20/1981

    Owner Heir - Open Estate Heir- Closed Estate Heir - Small Estate Trust
    Relationship to Original Owner:
    Open Business Closed Business Power of Attorney Other

    B. Property Information
    Owner Company Type of Property Property ID Value

    KEITH N, LOVELY
    42 LORRAINE AVENUE
    NORTH SMITHFIELD , RI 02896 MISC OUTSTANDING
    CENLAR FSB 3188990 $104.43
    CHECKS
    LAURA B, ALDEN
    42 LORRAINE AVENUE
    NORTH SMITHFIELD , RI 02896

    TOTAL PROPERTY CLAIMED Cash: $104.43

    C. Stock Information
    NOT APPLICABLE

    D. Documentation Required
    PHOTO ID(S) Please provide a current driver’s license(s) or other official
    government identification.

    ADDRESS Please provide proof that you lived at or did business from
    the reported address for each property claimed or proof of
    having done business with the reported holder. Examples of
    such proof may include old utility or tax bills, a pay stub or
    otherdocuments that shows the name of the property owner
    at the reported address.

    SOCIAL SECURITY NUMBER Please provide the Social Security Number for each claimant.

    SIGNATURE(S) Please return the Claim Form with all required signature(s).
    Claim ID: 5358404
    E. Affidavit

    Each of the undersigned affiants (signatory), being first duly sworn, deposes and states: That affiant(s) is/are
    the claimant(s) in the foregoing claim; that affiant(s) has read the foregoing claim and knows the contents
    thereof; that the same is true of affiant's own knowledge; that the money or property involved has not been
    received by affiant(s); that affiant(s) is/are the sole owner(s) of said claim and sole person(s) entitled to
    receive the property set forth in said claim; and that affiant(s) agrees to indemnify, hold harmless and
    release from liability the State of Rhode Island, its officers and employees, from any loss resulting from the
    payment of said claim. If claimant resides outside of the United States in a foreign country, it must be
    notarized at a U.S Consulate, U.S Embassy or provide apostille authentication.

    Signature of Claimant Date

    2nd Claimant Signature (Joint Accounts) Date

    Final Instructions
    Please return the completed claim form along with the documentation listed in Section D to our office at your
    earliest convenience.

    • You may upload the claim form and documentation via our website at
    https://findrimoney.com/app/claim-doc-upload.
    • You may mail the documentation to our office at the address listed below:

    Rhode Island Unclaimed Property Division


    P.O. Box 1435
    Providence, RI 02901-1435

    If you have any questions or concerns about the information required on the claim form, please contact our
    office (401) 462 -7676.

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