PAGE 48
If your name is on this list, you may have $100 or more waiting
YEN LEOe
YEN tY E AVE LOX#
I4Uk. Stl 16112 OLAYTON I C0 CA
YEGF4 MV' M6
fe;ON , Nak MS
YGLEOA VES, PO 80X 31 OL4.fl MS
yLIt$5 TEE t PO BOX 251 LF MS
IIALO DAN. 003 HWY 51 N NSBfl MS
Y J$L RI38OXf3&PAmA0R BAYSTtOS.
YOKOIA M MS
YON IW J fAe4ON AD Rl 3 X 06 H0LY 5 Me5
YONC£ GCOTT 510 N : AVE APT f HAm MS
Y04 DAO E P 8OX 9 RK(Y SAL C B0VN, S
Y L PAYO LAN NNL MS
P M APTI THSTN COtLBL
vOf fO 1 ELAO ST LAVNOA YO DT MS
v ]l 239 5TEl JACLINE YO M S
¥OST $ 213 PAP AVL ATT MS
YOU CISO0 eO 90X JSL 4ffY MS
Y ALL P
Y ALV^J l El 9TH ST I06 C YAZO
YOUNG ALVAW MS
Y AP.L, 54 ($1OArJ 4 RT 1¢ GLFP0T MS
YOUN 4A t02CR STIM
YO RGV fOBOx231 CLESTON. MS
Y BLtY 715 I LP YOU M
YO 8LYW BtL¥WY 40 BOX M
YOUNG YLEE 57791Y WAL[
Y 5N SA STHm v JMS
CtBUR W P BOX C D0LA C YOUN rLt MS
YO EYATA ker$ B 33 ELLAr 0L4 MS
r imm mmm mmm mmm imm
CLAR¢JE E &l
E'&L MS
Nursing Homes
BLCLEGE BRB
CE CECL LN W
CY C.TV GEE U
COTS CS UNKNC,e,
ZEPBT FPS.S C LCr
JCT LLE VEE
C;ST LY ;. S LE LE ACC ", S
UNCLAIMED PROPERTY FORM--"
IF YOUR NAME APPEARS ON THIS LIST, PLEASE FILL OUT THIS FORM. Property ID
W;LTEV
NAME AND ADDRESS AS IT APPEARS ON LIST."
; 1.Your Last Name ', T__2. Your First name 1 3. Middle initial l 4, Maiden name --
5. Mailing address ] 6. City 7 State I 8. Zip code
!
9. Telephone number with area code
10. Social Security Number
11. Check one
__ Owner of property
Previous holder of property
__ Guardian, executor, administrator or other representative
__ Heir where there has been no probate
__ Beneficiary or co-owner of an account by owner who is now deceased
Other - Explain
Attach all documents supporting claim to this form, with current driver's license and...
i.e. proof of old address, telephone number, account or busine-s re¢ocds necessary. All claimants to the above named account must sign this d.aim and have it proper
If the claimant is a Corporation, the chief fiscal o of a public corporation, an officer of a private corporation or unincorporated association must execute form. A partr
ship. ff you are an heir please state your relationship and list other heirs on the back of this form.
The named claimant hereby certifies that this claim for property presumed abandoned is valid and just, that all statements herein are true and cerrect and that upon payment of this claim
nify and hold harmless the State, its officers and employees, from any other valid claims to the said property.
IFYOU HAVE ENTERED INTO A CONTRACT WITH AN HEIR FINDER, YOU MUST ENCLOSE A COPY OFTHE CONTRACT FOR OUR REVIEW.
!
I
I
I
I
I
I
I
I
L,
Subscribed and sworn to before me this
__Day of , 20
Notary PubEtc County/State
My commission expires
*******Second signature (if applicable )*******
__Day of , 20____
Notary Public
My com.mission expires
County/State
Fum UP-3 f SepL 2002 PRINTED ON RECYCLED PAPER
Signature(s) of ALL Claimants
mm m m m n mm m m mm m m m n mm m m m m m
LI
PAGE 48
If your name is on this list, you may have $100 or more waiting
YEN LEOe
YEN tY E AVE LOX#
I4Uk. Stl 16112 OLAYTON I C0 CA
YEGF4 MV' M6
fe;ON , Nak MS
YGLEOA VES, PO 80X 31 OL4.fl MS
yLIt$5 TEE t PO BOX 251 LF MS
IIALO DAN. 003 HWY 51 N NSBfl MS
Y J$L RI38OXf3&PAmA0R BAYSTtOS.
YOKOIA M MS
YON IW J fAe4ON AD Rl 3 X 06 H0LY 5 Me5
YONC£ GCOTT 510 N : AVE APT f HAm MS
Y04 DAO E P 8OX 9 RK(Y SAL C B0VN, S
Y L PAYO LAN NNL MS
P M APTI THSTN COtLBL
vOf fO 1 ELAO ST LAVNOA YO DT MS
v ]l 239 5TEl JACLINE YO M S
¥OST $ 213 PAP AVL ATT MS
YOU CISO0 eO 90X JSL 4ffY MS
Y ALL P
Y ALV^J l El 9TH ST I06 C YAZO
YOUNG ALVAW MS
Y AP.L, 54 ($1OArJ 4 RT 1¢ GLFP0T MS
YOUN 4A t02CR STIM
YO RGV fOBOx231 CLESTON. MS
Y BLtY 715 I LP YOU M
YO 8LYW BtL¥WY 40 BOX M
YOUNG YLEE 57791Y WAL[
Y 5N SA STHm v JMS
CtBUR W P BOX C D0LA C YOUN rLt MS
YO EYATA ker$ B 33 ELLAr 0L4 MS
r imm mmm mmm mmm imm
CLAR¢JE E &l
E'&L MS
Nursing Homes
BLCLEGE BRB
CE CECL LN W
CY C.TV GEE U
COTS CS UNKNC,e,
ZEPBT FPS.S C LCr
JCT LLE VEE
C;ST LY ;. S LE LE ACC ", S
UNCLAIMED PROPERTY FORM--"
IF YOUR NAME APPEARS ON THIS LIST, PLEASE FILL OUT THIS FORM. Property ID
W;LTEV
NAME AND ADDRESS AS IT APPEARS ON LIST."
; 1.Your Last Name ', T__2. Your First name 1 3. Middle initial l 4, Maiden name --
5. Mailing address ] 6. City 7 State I 8. Zip code
!
9. Telephone number with area code
10. Social Security Number
11. Check one
__ Owner of property
Previous holder of property
__ Guardian, executor, administrator or other representative
__ Heir where there has been no probate
__ Beneficiary or co-owner of an account by owner who is now deceased
Other - Explain
Attach all documents supporting claim to this form, with current driver's license and...
i.e. proof of old address, telephone number, account or busine-s re¢ocds necessary. All claimants to the above named account must sign this d.aim and have it proper
If the claimant is a Corporation, the chief fiscal o of a public corporation, an officer of a private corporation or unincorporated association must execute form. A partr
ship. ff you are an heir please state your relationship and list other heirs on the back of this form.
The named claimant hereby certifies that this claim for property presumed abandoned is valid and just, that all statements herein are true and cerrect and that upon payment of this claim
nify and hold harmless the State, its officers and employees, from any other valid claims to the said property.
IFYOU HAVE ENTERED INTO A CONTRACT WITH AN HEIR FINDER, YOU MUST ENCLOSE A COPY OFTHE CONTRACT FOR OUR REVIEW.
!
I
I
I
I
I
I
I
I
L,
Subscribed and sworn to before me this
__Day of , 20
Notary PubEtc County/State
My commission expires
*******Second signature (if applicable )*******
__Day of , 20____
Notary Public
My com.mission expires
County/State
Fum UP-3 f SepL 2002 PRINTED ON RECYCLED PAPER
Signature(s) of ALL Claimants
mm m m m n mm m m mm m m m n mm m m m m m
LI
