Fillable Unclaimed Property Inquiry (Michigan)

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Unclaimed Property Inquiry (Michigan)

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Michigan Department of Treasury
3433 (Rev. 09-21)
Unclaimed Property Inquiry
Issued under authority of Public Act 29 of 1995.
Read the instructions on page 2 before completing this form.
PART 1: CLAIMANT/PROPERTY OWNER INFORMATION
Property Owner’s Name (include current and all former names) Property Owner’s Social Security or Federal Employer Identication Number
Claimant Name Relationship to Property Owner Claimant’s Social Security or Federal Employer Identication Number (if dierent)
Current Address (Number and Street) Property Number(s)
City, State, ZIP code Daytime Telephone Number
E-mail Address
PART 2: FORMER ADDRESSES. List ALL former Michigan addresses used by the property owner. Attach a separate list, if necessary.
Street Address City, State, ZIP Code
PART 3: DECEASED PROPERTY OWNER. Refer to instructions for list of required documentation.
1. Did the Decedent have a Will? Yes No
2. Did the Decedent have a Trust? Yes No 2b. Is the Trust open? Yes No
3. Did the Decedent have a Probated Estate? Yes No 3b. Is Probated Estate open? Yes No
PART 4: CLAIMANT CERTIFICATION
Under penalties of perjury, I certify that the information provided on this inquiry form is true to the best of my knowledge. Upon payment
of this claim, said claimant will indemnify and hold harmless the State of Michigan, ocers and employees from any damages, claims
or losses of any kind resulting in payment of the property being claimed.
SUBSCRIBED AND SWORN TO BEFORE ME THIS SIGNATURE(S) OF CLAIMANT(S)
DAY OF , 20
NOTARY PUBLIC COUNTY, STATE
MY COMMISSION EXPIRES
Return completed form along with a copy of a picture identication, social security card, and required documentation (see page 2) to:
Michigan Department of Treasury
Unclaimed Property
P.O. Box 30756
Lansing, MI 48909
Allow 120 days for processing.
www.michigan.gov/unclaimedproperty
Any additional properties that may belong to
you will be added to your claim.
Oce Use Only
Approvals: 1. 2. 3. 4. 5.
Reset Form
3433, Page 2
Instructions for Form 3433,
Unclaimed Property Inquiry
FORM INSTRUCTIONS
Part 1. Complete applicable elds.
Part 2. List ALL former Michigan addresses used by the
property owner, including P.O. Boxes.
Part 3. If property owner is deceased, answer all questions
and provide required documentation.
Part 4. Sign in front of a Notary Public and have form
notarized.
REQUIRED DOCUMENTATION
Individual Property Owner
Submit copies of the following documents (originals will
not be returned):
• Picture ID (driver’s license or identication card)
• Social Security card. Alternatively, you may provide a
W-2, 1099, health insurance card, or other government-
issued tax document verifying your complete Social
Security number.
• If your name diers from how it appears on the Unclaimed
Property Web site, submit legal documentation supporting
the name change (e.g. marriage certicate, adoption
papers, divorce decree, etc.).
Claimant Other Than Property Owner
Submit copies of the following documents:
Parent on Behalf of a Minor
• Parent’s picture ID (driver’s license or identication card)
• The minor child’s birth certicate and social security card.
Guardian, Conservator, Trustee or Legal
Representative
• Claimant’s picture ID
• Property owner’s picture ID and social security card
• Court documents or other signed legal documents giving
you authority to act on the property owner’s behalf.
Deceased Property Owner
All questions in Part 3 must be answered in order to process
your inquiry. All claims on behalf of deceased owners must
include the following documentation (originals will not be
returned):
• Copy of Death Certificate
• Proof of your relationship to decedent (birth
certificate, marriage license)
Documentation required:
1. Did decedent have a Will?
If yes, provide copy of Will.
2. Did decedent have a Trust?
If yes, provide a copy of the Trust.
Is the Trust open?
If yes, the Trustee is entitled to claim the property
on behalf of the Trust, the Trustee will need to
complete this form.
3. If the decedent had a Probated Estate
Provide the following:
• If open, send a current copy (dated within last
12 months) of your Letters of Authority issued by
the probate court certifying your appointment.
• If closed, send a copy of the initial application/
opening petition for Probate and the Testimony to
Identity Heirs.
• A list of current addresses of all heirs.
Business Property Owner
Submit copies of the following documents:
• Business card
• Articles of Incorporation or DBA showing ownership
of the business and name changes.
• List of subsidiaries that entity can claim on behalf of.
• Documentation showing authorization for you to act
on behalf of the business entity shown as the original
property owner.
Closed (But Not Sold) Entities
• Final Federal tax return led including Schedule K
Sold Entities
• Buy/sell agreement showing who owned the accounts
receivable at the close of sale.
Dissolved Entities
• Dissolution papers and/or the automatic dissolution
papers and a copy of the nal corporate Federal tax
return, including Schedule K.
• List of current addresses of all shareholders.
You may also be required to complete a formal
claim form and provide additional documentation.
A
llow 120 days for processing from the date form was
mailed.
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Unclaimed Property Inquiry (Michigan)

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Completed 16 February 2022

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