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Claimant is required to provide the City with (City of Killeen, Texas)

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U.S.A. forms for City of Killeen, Texas

BROWSE CITY OF KILLEEN, TEXAS (TX) FORMS

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City of Killeen Mail Completed Form To:
Unclaimed Property Claim Form City of Killeen
For Business Owner
Finance Department
Attention: Unclaimed Property
P.O. Box 1329
Killeen, TX 76540-1329
Name: Drivers License #:
Address: Social Security #:
Date of Birth:
Home Phone: Work Phone:
Email Address: Claim Amount:
Claim Type:
Municipal Court Utility Collections Other
Please attach the following:
1. Copy of Driver’s License or other government issued photo identification.
2. Proof of Social Security Number (not required, but might help verify ownership)
Corporation or Limited Liability Company – Attach a copy of last public information report (PIR) filed with your franchise tax report.
Professional Association or Non-Profit Corporation – Attach a copy of last annual statement filed with the Secretary of State or a copy
of the Articles of Incorporation.
Private Organization, Group or Association – Attach a document establishing your authority to act.
Sole Ownership of Business – Attach a copy of your Assumed Name Certificate or a copy of your sales tax permits and enter:
Owner’s Name Social Security #:
Partnership – Attach a copy of the partnership agreement including the names and social security or FEI number of two partners.
Exceptions – Indicate if applicable and attach copies of requested documents.
Closed - Attach a copy of the Articles of Dissolution (including Attachment A) or Corporate Liquidation form filed with IRS.
Name Changed - Assumed/Merged – Attach a copy of the Change of Name Amendment or Assumed Name Certificate.
Purchased/Sold - Attach a copy of the Buy/Sell Agreement.
Signature: Date:
Approved Disapproved Original Check #:
Reason for Disapproval:
New Check #:
Amount:
Reviewed by: Date:
Approved by: Date:
FOR FINANCE DEPARTMENT USE ONLY
The named Claimant 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, Claimant will indemnify and hold harmless the City of Killeen and its officers and employees
from any damages, claims, or losses of any kind resulting from the payment of the above described property to Claimant.
Claimant Information
Indicate below the current status of the business and attach the requested documentation, indicating your authority to act.
Failure to provide your identification, signature, or completion of this claim form could result in the return of the form to you.
Claimant Certification and Signature
Instructions:
Claimant is required to provide the City with sufficient documentation to establish Claimant’s right to receive unclaimed property. As the
Claimant for a business, attach documents supporting your position with the company/business giving you authority to make a claim.
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Completed 1 February 2021

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