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APPLICATION FOR
CERTIFICATE OF
FINDER REGISTRATION
Pennsylvania Fiscal Code Sections
1301.11, 1301.11(a), 1301.11(b) and 1301.11(c)
INSTRUCTIONS
APPLICATION FOR CERTIFICATE OF FINDER REGISTRATION
All questions must be typewritten or written in black or blue ink. All answers must be legible. The Department will view
illegible answers as blank answers. All questions must be answered completely. If an answer is not applicable, indicate as
much.
All supplemental answers must include the number of the corresponding question.
Question 1. List the e-mail address and telephone number that will be used on your contracts unless you have a company.
Question 2. This question must only be answered if you are operating as a nder from a business. Please be advised that
all individuals who operate as nders in Pennsylvania need to obtain a nder registration number even if they
work for the same company. The nder registration number belongs to the individual not the business.
For example: ve employees from ABC Finder Company operate as nders in Pennsylvania then ve nder
registration numbers must be issued. It does not matter where the employee is physically headquartered
or where the claimants reside as long as the employee is in the business of nding property reported to
Pennsylvania for claimants, they need to obtain a registration number.
Question 3. If you answered yes, you must provide the information requested.
Question 4. This includes a conviction or guilty plea in Pennsylvania as well as in another state or the federal jurisdiction.
If the answer is yes, you must detail the crimes you pled guilty to or were convicted of as well as the
circumstances surrounding the crimes. You may include any extenuating circumstances that you believe
Treasury should take into consideration when evaluating your application.
Question 5-7. It is incumbent upon the applicant to answer these questions honestly. If an applicant is unsure if a plea or
conviction in another jurisdiction is applicable, the applicant should still disclose on a separate sheet of paper
the plea or conviction and the circumstances surrounding such conviction.
No applicant should fail to disclose pleas or convictions because they believe such pleas or convictions were
cleared from their criminal record. Often the records are not ofcially cleared and are still part of your
criminal record. Failure to disclose may result in a denial.
Question 8. An administrative agency is any agency of federal, state and local government that may investigate citizens
for infractions of criminal or civil laws. For example, the Pennsylvania Department of State provides
professional licenses and investigates infractions of both criminal and civil law. Such investigations must be
disclosed.
Question 9. You must disclose the bankruptcy, make note of the circumstances surrounding the bankruptcy and the status
thereof.
Question 10. You must provide your nder agreement contract. This must be the nder agreement contract you will use
for all property held by the Pennsylvania Treasury Department. Please be advised it may be considered a
violation of your registration if the agreement that you provide to your clients is different from the agreement
submitted with your application and you failed to amend it with the Ofce of Investigations.
Question 11. These character references are a must.
COMPLETED APPLICATION AND ACCOMPANYING FORMS
• You must include with your application the following:
1. Application with all questions answers and all required supplemental sheets
2. Recent full-face color photograph
3. Copy of your driver’s license or state issued identication card
4. Original notarized character reference letters
5. Copy of current contract that you used for Pennsylvania claimants
6. Notarized Applicant Certication and Acknowledgement (last page of Application)
TREASURY WILL ONLY EVALUATE AND PROCESS COMPLETE APPLICATIONS FOR REGISTRATION.
Failure to completely answer questions or to provide supplemental information will cause your application to be
deemed incomplete. Any incomplete applications will be returned to applicant without being processed.
• IF YOUR APPLICATION IS COMPLETE PLEASE SEND IT TO:
Ofce of Investigations 127 Finance Building
Harrisburg, PA 17120
PH – 717.787-1606
For your information
• It takes an average of 60 days for Treasury to evaluate applications.
• If you receive a registration, it must be listed on all claim forms with which you are associated.
APPLICATION FOR CERTIFICATE OF
FINDER REGISTRATION
Pennsylvania Fiscal Code Sections 1301.11, 1301.11(a), 1301.11(b) and
1301.11(c)
Type or print using black or blue ink
Pursuant to the Unclaimed Property Act, this Application for Certicate of Finder Registration (“Application”) is to be completed
by any person wishing to engage in any activity for the purpose of locating, delivering, recovering, or assisting in the recovery of
unclaimed property, and receive a fee, compensation, commission, or other remuneration for such activity. A separate form must
be completed and submitted by each and every individual seeking to engage in this activity for compensation. Upon the ling of
the Application, the Pennsylvania Treasury Department (“Treasury”) may investigate the applicant to verify the information provided
and to determine the applicant’s eligibility for a Certicate of Finder Registration.
All questions must be completed. All supplemental answers provided to Treasury on separate sheets of paper must be type written
and include the number of the corresponding question. Please be advised that you must provide all required documentation
before Treasury will begin processing your application. Your application will not be deemed complete and ready for review
unless all required documentation is provided.
Note: Condential personal information may be accessed by Treasury employees in order to process, review and/or
approve or deny your Application. The information requested is required for the processing of your Application, and if such
information is not provided, Treasury may stop processing and/or deny your Application. By submitting an Application, you
are providing your consent for Treasury employees to access condential personal information for this purpose.
1 Name of Applicant:
Home Address:
City, State, Zip Code:
Social Security Number:
Telephone Number:
E-Mail Address:
2. Company Name:
Doing Business As:
Company Address:
City, State, Zip Code:
Federal Tax ID Number:
Telephone Number:
E-Mail Address:
Certicate of Registration Application | Page 1 of 5
3. If you are a Pennsylvania resident, have you worked or resided outside Pennsylvania at any time during the preceding ten
(10) years? If yes, provide on a separate sheet of paper your residential addresses outside Pennsylvania and the names,
addresses, and telephone numbers of the employers for whom you worked. Yes _____ No _____
4. During the ten (10) year period immediately preceding submission of this Application, have you ever pled guilty to or been
convicted of a felony in Pennsylvania or any other jurisdiction. Yes _____ No _____ If yes, please explain on a separate
sheet of paper the circumstances surrounding the conviction, which must be attached to this Application.
5. During the ten (10) year period immediately preceding the submission of this Application, have you ever pled guilty to or
been convicted of the following theft or theft related offenses under 18 Pa.C.S. Chapter 39 or its equivalent if committed
in another jurisdiction (including federal):
a. Theft by unlawful taking or disposition Yes _____ No _____
b. Theft by deception Yes _____ No _____
c. Theft by extortion Yes _____ No _____
d. Theft of property lost, mislaid or delivered by mistake Yes _____ No _____
e. Receiving stolen property Yes _____ No _____
f. Theft of services Yes _____ No _____
g. Theft by failure to make required disposition of funds received Yes _____ No _____
h. Unauthorized use of automobiles and other vehicles Yes _____ No _____
i. Retail Theft Yes _____ No _____
j. Library Theft Yes _____ No _____
k. Unlawful possession of retail or library theft instruments Yes _____ No _____
l. Organized retail theft Yes _____ No _____
m. Theft of trade secrets Yes _____ No _____
n. Theft of unpublished dramas and musical compositions Yes _____ No _____
o. Theft of leased property Yes _____ No _____
p. Theft of motor vehicle Yes _____ No _____
If you checked yes to any of the theft related offenses above, please explain the circumstances surrounding the conviction
or plea on a separate sheet of paper, which must be attached to this Application.
If you checked “no” to all of the offenses in 5, please read and initial after the following statement:
I hereby attest under Section 4904 of the Pennsylvania Crimes Code and penalty of perjury that I have never been convicted or
pled guilty to any of the above-mentioned theft offenses in Pennsylvania or any other jurisdiction. initials
6. During the ten (10) year period immediately preceding the submission of this Application, have you ever pled guilty to or
been convicted of the following forgery or fraudulent related offenses as set forth in 18 Pa.C.S. Chapter 41 or its equivalent
if committed in another jurisdiction (including federal):
a. Forgery Yes _____ No _____
b. Simulating object of antiquity, rarity, etc. Yes _____ No _____
c. Fraudulent destruction, removal or concealment of recordable instruments Yes _____ No _____
d.
Tampering with records or identication Yes _____ No _____
e.
Bad checks Yes _____ No _____
f. Access device fraud Yes _____ No _____
g. Unlawful device-making equipment Yes _____ No _____
h. Deceptive or fraudulent business practices Yes _____ No _____
i. Deception relating to kosher food products Yes _____ No _____
j. Deception relating to certication of minority business enterprise or
women’s business enterprise Yes _____ No _____
Certicate of Registration Application | Page 2 of 5
k. Commercial bribery and breach of duty to act disinterestedly Yes _____ No _____
l. Rigging publicly exhibited contest Yes _____ No _____
m. Defrauding secured creditors Yes _____ No _____
n. Fraud in insolvency Yes _____ No _____
o. Receiving deposits in a failing nancial institution Yes _____ No _____
p. Misapplication of entrusted property and property of government or
nancial institutions Yes _____ No _____
q. Securing execution of documents by deception Yes _____ No _____
r. Falsely impersonating persons privately employed Yes _____ No _____
s. Copying; recording devices Yes _____ No _____
t. Unlawful operation of recording device in motion picture theater Yes _____ No _____
u. Insurance fraud Yes _____ No _____
v. Washing vehicle titles Yes _____ No _____
w. Trademark counterfeiting Yes _____ No _____
x. Identity theft Yes _____ No _____
If you checked yes to any of the fraud related offenses above, please explain the circumstances surrounding the
conviction or plea on a separate sheet of paper, which must be attached to this Application.
If you checked “no” to all of the offenses in 6, please read and initial after the following statement:
I hereby attest under Section 4904 of the Pennsylvania Crimes Code and penalty of perjury that I have never been convicted
or pled guilty to any of the above-mentioned forgery or fraudulent related offenses in Pennsylvania or any other jurisdiction.
initials
7. During the ten (10) year period immediately preceding the submission of this Application, have you ever pled guilty to or
been convicted of the following perjury, false swearing, fraud or other related offenses as set forth in 18 Pa.C.S. Chapter
49 or its equivalent if committed in another jurisdiction (including federal):
a. Perjury Yes _____ No _____
b. False swearing Yes _____ No _____
c. Unsworn falsication to authorities Yes _____ No _____
d. False alarms to agencies of public safety Yes _____ No _____
e. False reports to law enforcement authorities Yes _____ No _____
f. False reports of child abuse Yes _____ No _____
g. Witness or information taking bribe Yes _____ No _____
h. Tampering with or fabricating physical evidence Yes _____ No _____
i. Tampering with public records or information Yes _____ No _____
j. Impersonating a public servant Yes _____ No _____
k. Impersonating a notary public or holder of a professional or
occupational license Yes _____ No _____
l. False identication to law enforcement authorities Yes _____ No _____
m. Failure to comply with registration of sexual Offenders requirement Yes _____ No _____
n. Failure to comply with registration requirements Yes _____ No _____
If you checked yes to any of the fraud related offenses above, please explain the circumstances surrounding the
conviction or plea on a separate sheet of paper, which must be attached to this Application.
If you checked “no” to all of the offenses in 7, please read and initial after the following statement:
I hereby attest under Section 4904 of the Pennsylvania Crimes Code and penalty of perjury that I have never been convicted
or pled guilty to any of the above-mentioned forgery or fraudulent related offenses in Pennsylvania or any other jurisdiction.
initials
Certicate of Registration Application | Page 3 of 5
8.
Did you act as a nder in Pennsylvania previous to the registration requirement? Yes _____ No _____
If you answered yes to number 8, please answer the following questions:
a. Did you ever violate the Pennsylvania Disposition of Abandoned and Unclaimed Property Act, including
charging clients and/or unclaimed property claimants more than 15% of the value of property?
Yes _____ No _____. If yes, please explain the circumstances on a separate sheet of paper that must
be attached to this application.
b. Have you ever been the subject of an investigation by a state, county or local administrative agency?
Yes _____ No _____. If yes, please explain the circumstances on a separate sheet of paper that must
be attached to this application.
9.
Have you or has your business led for bankruptcy in the last ten (10) years? Yes _____ No _____. If yes, please explain
the circumstances and status of the bankruptcy on a separate sheet of paper that must be attached to this Application.
10.
Please submit a copy of your unclaimed property nder contract that will be provided to claimants.
11. You must also provide Treasury with two character references along with a written statement from each. The written
statements must be attached to this application and the character witnesses contact information must be completed below.
Treasury may contact these witnesses when processing this Application. Please be advised that the character references
may not include family members, current employees or subcontractors.
a. Character Witness Name:
Address:
City, State, Zip Code:
Telephone Number:
b. Character Witness Name:
Address:
City, State, Zip Code:
Telephone Number:
12. I understand the following:
Should I be granted a registration to act as an unclaimed property nder in Pennsylvania, I will faithfully follow the
Disposition of Abandoned and Unclaimed Property Act (72 P.S. § 1301.1 et seq.), any unclaimed property regulations set
forth in the Pennsylvania Code, and any Bureau of Unclaimed Property policies. I understand that by law my fee must not
exceed of fteen (15%) of the value of the unclaimed property. I further understand that Treasury will both investigate
my application and, if I am approved for a registration, may initiate an investigation for any allegation or complaint of
misconduct. I understand that Treasury may revoke my registration in accordance with the provisions of the Disposition
of Abandoned and Unclaimed Property Act. (initials)
Certicate of Registration Application | Page 4 of 5
Mail: (1) Application, (2) recent full-face color photograph, (3) a copy of your driver’s license or state issued identification
card (4) original, notarized character reference letters from above-listed references, and (5) copy of a current contract that you will
use for Pennsylvania claimants
1
to:
Ofce of Investigations 127 Finance Building
Harrisburg, PA 17120
PH – 717-787-1606
Email – nderregistration@patreasury.gov
Applicant Certication and Acknowledgement
I do hereby certify that I have not, during the ten year period immediately preceding
the submission of this application, violated, been convicted, or pled guilty to any crimes
enumerated in Chapters 39, 41 or 49 in the Pennsylvania Crimes Code as specified above.
I further certify, under penalties of perjury, that all the information provided on this
Application for Registration is true and correct, and all supporting documentation
presented are original or true unaltered copies of the original documents. I acknowledge
that any false or perjured statement may subject me to criminal liability under Pennsylvania
Crimes Code Section 4904 and Sections 1301.25 of the Disposition of Abandoned and
Unclaimed Property Act. I acknowledge that any false information, or the discovery of any
disqualifying information, may be grounds for the denial or revocation of a certificate of
registration.
I certify that I have read and will abide by the requirements of the Disposition of Abandoned
and Unclaimed Property Act. I will hold the Commonwealth of Pennsylvania and Tre a s u ry
Department, its ofcers and employees, harmless from any damages, losses, or claims of any kind
resulting from my submission of this Application for Registration and any denial, or subsequent
revocation, of the approval to engage in activities under the Disposition of Abandoned and
Unclaimed Property Act, as well as any damages, losses, or claims of any kind arising from
a nding that an agreement entered into pursuant to the Disposition of Abandoned and
Unclaimed Property Act is invalid.
Applicant’s Signature Date
State of
County of
This Application for Registration was signed, in my presence, by Applicant, and sworn before
me on this _________________day of____________ , 20_____.
Seal or Stamp
Notary Public Signature
1.
Please be advised that any changes to your nder contract must be submitted as an amendment to your application for registration as long as
you are a registered Pennsylvania nder.
Certicate of Registration Application | Page 5 of 5
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Completed 25 May 2022

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