Claimant Affidavit Unclaimed Property

In the event proof of ownership to unclaimed property can not be substantiated, the claimant may, for the Department’s consideration, file an affidavit swearing to the authenticity of the claim and to the lack of documentation and agreeing to the release of the claimant’s name and address by the Department to subsequent claimants providing substantiated proof of entitlement to the unclaimed property. The affidavit must be accurately completed. The claimant must state on the affidavit why the claimant is entitled to the unclaimed property. The affidavit must be signed by the claimant and on the dame day the affidavit is dated by the claimant who must be the “apparent owner” as defined by Section 717.101(2), F.S. No person shall place any writing or other information on the affidavit after the affidavit has been signed and dated by the claimant. The affidavit shall be submitted on Form DFS-A4-2006, Claimant Affidavit effective 10-13-10, which is hereby incorporated by reference and available from the Department of Financial Services, Bureau of Unclaimed Property, 200 East Gaines Street, Tallahassee, Florida 32399-0358. This section applies only if all of the unclaimed property held by the Department on behalf of the claimant for which entitlement has not been established has an aggregate value of $250 or less.

Rulemaking Authority 717.138 FS. Law Implemented 117.05, 717.101(2), 717.124(3) FS. History–New 1-28-97, Amended 4-16-02, Formerly 3D-20.0026, Amended 10-13-10.