for any claim which then exists or which thereafter may arise or be made in respect to the property (NRS 120A.570).
That thereafter the contents of such safe deposit box were:
[ ] Other: .
Charge for forcible entry
In witness whereof, we have hereunto set our hands at
The Nevada State Treasurer, as the administrator of Unclaimed Property, takes custody of the contents shown for the above listed
owner(s) and is responsible for its safekeeping. The holder is relieved of all liability to the extent of the value of the property delivered
Signature of Holder Official
Returned to the safe deposit box in total.
Returned to the safe deposit box with the exception of
Signature of Acceptor of Property
Signature of Notary Public
Contents turned over to the State of Nevada as Unclaimed Property under NRS120A.510 on this date ________
THIS SECTION TO BE USED IF CONTENTS BECOME UNCLAIMED
Sealed in a package by the undersigned notary public, together with a duplicate of this certificate and the name of the
Mailed to the lessee by certified or registered mail in accordance with lessee's written instructions dated:
lessee and the date of opening of the safe deposit box were written on the outside of the package by the undersigned
notary public in the presence of a bank officer, and a copy of this certificate was sent by certified mail, addressed to
the lessee at the last known address of the lessee (NRS 663.085).
Signature of State Official
Signature of Bank Officer
(Agency) in accordance with search warrant
in accordance with court order
State of Nevada, County of
Signed and sworn to before me on