Sample Affidavit for Unclaimed Funds Claim, In the event you can not show proof of residence on file in NYS
- homelesslongisland
- May 8
- 2 min read
Affidavit for Unclaimed Funds Claim
[Your Name]
[Your Address]
[City, State, ZIP Code]
[Email Address]
[Phone Number]
Date: [Insert Date]
Affidavit of [Your Full Name]
I, [Your Full Name], being duly sworn, depose and say:
1. Identity: I am the individual named in the claim for unclaimed funds held by the New York State Office of Unclaimed Funds.
2. Connection to New York: I confirm that I resided at [Address on File] in New York approximately ____ years ago. However, due to the passage of time, I am unable to produce specific documents to verify my residency during that period.
3. Supporting Information: While I cannot provide direct proof of residence, I can provide alternative documentation that supports my claim, including but not limited to:
Delete the reason that do to pertain to your situation.
A- Previous bank statements referencing the New York address.
B- Affidavits from individuals who can attest to my residence at the listed address during the relevant timeframe.
C- Other documents that suggest a connection to the property or funds in question.
4. Purpose: This affidavit is submitted to support my claim for unclaimed funds, recognizing that my circumstances may differ from traditional requirements but asserting my rightful claim to these funds.
I swear or affirm that the information provided above is true and correct to the best of my knowledge.
_____________________________
[Your Signature]
[Your Printed Name]
Sworn to and subscribed before me this ____ day of ________, 20
_____________________________
Notary Public
[Notary Public's Name]
[Notary Public's Commission Number]
[Notary Public's Seal]
Resource
For more information on unclaimed funds in New York, visit the New York State Office of Unclaimed Funds website (https://www.osc.state.ny.us/unclaimed-funds). You can also directly contact their office for assistance regarding claims and necessary documentation. They provide detailed guidance on how to file your claim and what alternatives may be accepted if proof of residence is not available.
Or Call Homeless Long Island
631-260-1363
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