RIVERSIDE COUNTY SHERIFF
UNCLAIMED MONEY
(Pursuant to Government Code 50052)

Unclaimed Money Form

Fill out this form online, print it, sign it, then attach the required documentation to this form and mail it to:
Riverside County Sheriff
ATTN: Accouting & Finance - Unclaimed Money
P.O. BOX 512
RIVERSIDE, CA 92501

Once your package is received with all the required documentation, it will be reviewed. Please do not inquire on the status of your claim unless it has been over 60 days from the date you mailed your package. Such calls will only delay disbursements.

Thank you for your patience.

Each of the undersigned claimants certifies, under penalty of perjury, that the claimant has read the claim and knows the contents thereof and that the claimant(s) is/are the owner(s) of the said claim and the person(s) entitled to receive the money set forth in the said claim.

Each claimant agrees to indemnify and hold harmless the Department, its officers and employees from any loss resulting from the payment of said claim.

Current information and signature must be provided for each claimant or the claim will be returned.
PROPERTY IDENTIFICATION NUMBER: 640 AMOUNT: $49.83
DEADLINE TO SUBMIT UNCLAIMED MONEY FORM IS: December 31, 2014

FIRST AND LAST NAME OR BUSINESS NAME:
 
CURRENT MAILING ADDRESS:
CITY, STATE/PROVINCE/ZIP/COUNTRY:
DAYTIME PHONE (WITH AREA CODE):
CLAIMANT'S OR AUTHORIZED AGENT'S SIGNATURE : X
DATE : X

Page 2: UNCLAIMED MONEY FORM

AS CLAIMANT(S), I/WE AM/ARE ENTITLED TO THE UNCLAIMED MONEY FOR THE FOLLOWING REASON(S): (Please provide detailed information on why the unclaimed money may belong to you. Refer to the filing instructions for additional information.)

 
 
 
 
 
 
 
 
 
 

I/We (Circle one)    HAVE    HAVE NOT   attached documentation to support my/our claim.

FAILURE TO PROVIDE THE REQUIRED DOCUMENTATION WILL RESULT IN THE CLAIM BEING DENIED FOR PAYMENT.

I/We understand that I/we must file my/our claim with the Riverside County Sheriff on or before the deadline date specified (postmark accepted) in the publication appearing in The Press Enterprise or the money in question will become the property of the County of Riverside. I/We also understand that should the Sheriff deny my/our claim, the law gives me/us the right to appeal. Should I/we wish to appeal, I/we must file a court complaint in Riverside County within 30 days of receipt of the Sheriff’s notice denying my/our claim.