Fillable City of Round Rock Unclaimed Property General Claim (City of Round Rock, Texas)

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City of Round Rock Unclaimed Property General Claim (City of Round Rock, Texas)

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The City of Round Rock Unclaimed Property General Claim (City of Round Rock, Texas) form is 2 pages long and contains:

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  • 18 other fields

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File type: PDF

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BROWSE CITY OF ROUND ROCK, TEXAS (TX) FORMS

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Page 1 of 2
City of Round Rock
Unclaimed Property
General Claim Form
The City of Round Rock holds property valued at $100 or less that is presumed abandoned or unclaimed subject to
Chapter 76 of the Texas Property Code. If you have unclaimed property, please submit this form and documentation
supporting your claim. All information will remain confidential.
Zip:
A) Proof of Claimant’s Social Security Number
B) Copy of Claimant’s Driver’s License or any official form of identification
C) Proof of previous address (Copy of utility bill, canceled check, etc.)
If the property is not in your name, please indicate your status on page 2 and provide the
additional documentation listed.
Claimant Signature
The named Claimant hereby certifies that this claim for property presumed abandoned is valid and just, that all
statements herein are true and correct, and that upon payment of this claim said Claimant will indemnify and hold
harmless the City of Round Rock, and it’s officers and employees for any damages, claims or losses of any kind
resulting from the payment of the above described property to the Claimant.
Date: Claimant:
Co-Owner: Date:
State:
Other number:
Claimant Information (must be 18 years or older)
Claimant name:
First
Middle
Last
Amount Claimed:
Required Documentation
The following documents must be provided along with this claim form for the claim to
be processed.
Address:
Apt. #: Ci
ty:
Daytime phone number:
Social Security Number or TPIN:
Previous address:
Page 2 of 2
Claims on behalf of someone else
If the property is not in your name, check the appropriate box below, attach
documents requested, and en
ter the applicable federal identification number.
Heir to the owner
Attach a copy of probated will, court order, or affidavit of heirship listing heirs
and current addresses AND a copy of the death certificate of the owner.
Deceased owner information needed below.
Trustee or guardian to the owner
Attach copies of current documents establishing guardianship of trust.
Executor or administrator for owner’s estate
Attach a copy of the death certificate AND Letters of Administration or
Testamentary dated within 90 days of filing claim.
Deceased owner information needed below.
Officer of the organization
Attach current documents establishing your authority to act for the
organization.
Parent of the owner who is under the age of 18
Attach a copy of minor’s birth certificate and proof of SSN.
Federal Numbers:
Deceased SSN:
Estate Trust Company TPID:
Mail to:
City of Round Rock
Finance Department
Attn: Unclaimed Property
221 East Main Street
Round Rock, TX 78664
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City of Round Rock Unclaimed Property General Claim (City of Round Rock, Texas)

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Completed 16 July 2020

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