GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS
GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR DIVISION OF BANKING, INSURANCE AND FINANCIAL REGULATION 5049 Kongens Gade, St. Thomas, VI 00802-6487 • Tel: 340-774-7166 • Fax: 340-774-9458 1131 King Street, Suite 101, Christiansted, VI 00820 • Tel: 340-773-6459 • Fax: 340-719-3801 `********* CLAIM OF ABANDONED PROPERTY The Claim of Abandoned Property is made pursuant to Title 28, Chapter 29 Virgin Islands Code Owner’s Name: Mailing Address: Claimant’s Name: Telephone Number: Home: Work: Other: Name of Institution: Account No.: Safe Deposit Box No.: Policy No.: Certificate No.: Amount: $ Contents Description: The following documents are attached in support of this claim: Passbook Affidavit of Lost Instrument Safe Deposit Receipt Other Certificate of Deposit Bank Certificate of Ownership Picture I.D. …
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GOVERNMENT OF THE UNITED STATES VIRGIN ISLANDS OFFICE OF THE LIEUTENANT GOVERNOR DIVISION OF BANKING, INSURANCE AND FINANCIAL REGULATION 5049 Kongens Gade, St. Thomas, VI 00802-6487 • Tel: 340-774-7166 • Fax: 340-774-9458 1131 King Street, Suite 101, Christiansted, VI 00820 • Tel: 340-773-6459 • Fax: 340-719-3801 `********* CLAIM OF ABANDONED PROPERTY The Claim of Abandoned Property is made pursuant to Title 28, Chapter 29 Virgin Islands Code Owner’s Name: Mailing Address: Claimant’s Name: Telephone Number: Home: Work: Other: Name of Institution: Account No.: Safe Deposit Box No.: Policy No.: Certificate No.: Amount: $ Contents Description: The following documents are attached in support of this claim: Passbook Affidavit of Lost Instrument Safe Deposit Receipt Other Certificate of Deposit Bank Certificate of Ownership Picture I.D. DATE: CLAIMANT’S SIGNATURE: *******FOR OFFICE USE ONLY******* Listing No: Year: Page No.: The claim has been allowed The claim has been denied: In Whole/In Part Director of Division of Banking, Insurance and Financial Regulation On behalf of the Abandoned Property Administrator ______________________________________ Signature