Levora REYNOLDS

Work checking patients in and out. I also reviewed payments.

• Name of Claimant
• Name of Co-Claimant
• Social Security / FEIN
• Telephone Number
• Present Mailing Address
• City, State, Zip
• Claimant Email
• Co-Claimant Email
• INDEMNIFICATION I, the claimant signing below, am the true owner. I swear and affirm that the forgoing statement and all facts and information set forth herein are true and correct as I verily believe. If I knowingly make any false statement with respect to this claim, I shall repay the Unclaimed Property Division the amount of the claim upon request and shall indemnify the Treasurer and the State of Tennessee in the event of a successful claim by another claimant.
• Full Signature of Claimant
• Full Signature of Co-Claimant

• Before returning the claim form, claimants
• Review A. Property Information;
• Complete B. Owner Information and Sign and Date Indemnification;
• Attach the documentation requested in C. Required Documents.
• Please return the signed claim form, along with copies of the documents listed in Section C, to our office at your earliest convenience. Originals
• Filing claims at ClaimItTN.gov will result in faster processing, so please upload the claim form and documentation via our website at https://UnclaimedProperty.tn.gov/app/claim-status-search.
• Or
• If you do not have access to the internet, you may mail the
• Treasury Department
• Division of Unclaimed Property
• PO Box 190693
• Nashville, TN 37219
• Depending on our current volume and the complexity of your claim it will take approximately 2-6 weeks to process your claim once we have received all the needed documentation.