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MISSOURI STATE TREASURER

***5973

UNCLAIMED PROPERTY - JEFFERSON CITY

P. O. Box 1004

Jefferson City MO 65102

573-***-****

FAX 573-***-****

RELAY MO/DEAF TTY 800-***-****

WWW.SHOWMEMONEY.COM

CLAIM FOR ASSETS PRESUMED ABANDONED (Asset Value: $11.18) THE ITEMS BELOW ARE DOCUMENTS REQUIRED BY THE UNCLAIMED PROPERTY DIVISION TO PROCESS YOUR CLAIM. RETURN THESE ITEMS TO THE ABOVE ADDRESS.

· Sign Claim Form (below). NOTARIZATION IS NOT REQUIRED.

· Copy of EACH Claimant's Drivers License (or photo ID) and verification of Social Security number (copy of Social Security Card OR provide the last 4 digits below)

ORIGINAL OWNER INFORMATION

Property ID Rltn Name Original Address City, State, Zip 13424553 SO FUHR LAQUITA 5118 INDIANA AVE KANSAS CITY, MO 64130 I hereby certify that the above statements herein are complete and that no information has been withheld regarding ownership of the abandoned account. In the event further inquiries are made regarding this account, I authorize the Office of the Missouri State Treasurer to refer these individuals to me for resolution of their inquiry/claim. I understand that any falsification or misrepresentation of this information will be cause for denial of this claim or legal action. Any person who assists in the recovery of property for a fee without being registered with the State Treasurer will be subject to penalties. CLAIMANT SIGNATURE: DATE: CLAIMANT(S) INFORMATION

Claimant I.D. Number 8235973 Social Security

FUHR LAQUITA

5118 INDIANA AVENUE

KANSAS CITY, MO 64130

XXX-XX-0721

(or Federal ID#)

Daytime Phone: 816-***-****

Email Address:

adxv21@r.postjobfree.com