Unclaimed Funds Form

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Please correct the field(s) marked in red below:

Claimants must be 18 or older. Claimant is required to provide the City with sufficient documentation to establish Claimant's right to receive unclaimed funds. Submitting your Social Security Number ("SSN") is required to verify your claim. To the extent permitted by law, your Social Security Number; and all other information provided will be kept confidential and never disclosed. The information you enter is under a high grade encryption for security purposes.
Claimant's First and Last Name
Claimant's SSN
Claimant's Current Address
Claimant's Current Address
Claimant's Phone Number
Claimant's Email Address
Please attach a copy of your driver's license or other official document used for identification and proof of Social Security Number
By submitting this form the named claimant certifies that this claim for funds presumed abandoned is valid and just, that all statements herein are true and correct, and that upon payment of this claim, Claimants will indemnify and hold harmless the City of Odessa, the Director of Finance, and its employees from any damages, claims, or losses of any kind resulting from the payment of the above funds to the Claimant.
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