Corporate Or Business Indentification Form For Unclaimed Dividends
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Corporate Or Business Indentification Form For Unclaimed Dividends Form. This is a Rhode Island form and can be use in Bankruptcy Court Federal.
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Tags: Corporate Or Business Indentification Form For Unclaimed Dividends, F.2, Rhode Island Federal, Bankruptcy Court
R.I. Bankr. Form F.2
See R.I. LBR 3011-1(b)
(Rev. 8/23/10)
UNITED STATES BANKRUPTCY COURT
FOR THE DISTRICT OF RHODE ISLAND
CORPORATE/BUSINESS IDENTIFICATION FORM FOR UNCLAIMED DIVIDENDS
Case Name
Case No.
Amount of dividend/refund
A dividend/refund check was previously issued in your name in accordance with an
Order of this Court, however said check was not cashed and has been deposited with the United
States Treasury Account.
In order to insure payment to the proper party, please fill out the identification portion on this
form and either electronically file (see LBR 3011-1), or mail the form to: U.S. Bankruptcy
Court, 380 Westminster St., Providence, RI 02903, Attn: Financial Dept. Upon receipt of the
completed document, your request for payment of unclaimed funds held by the Court will be
processed.
===============================================================
I,
, hereby state that I am the
(Title)
of
whose TIN# is _______________________, and that I am
(Business Name)
authorized to request payment of the above dividend.
(Signature)
(Corporate Seal)
Subscribe and sworn to before me in
(City/Town)
This
Day of
, 20
.
(State)
(Notary Public)
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