Get Holder Request For Reimbursement - Kentucky State Treasury

Filling out the Holder Request For Reimbursement from the Kentucky State Treasury is a straightforward process that allows users to claim funds they are entitled to. This guide provides clear, step-by-step instructions to help you complete the form with ease and accuracy.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to access the Holder Request For Reimbursement form and open it in your preferred online editor.
2. Enter the owner(s) name exactly as reported. This is crucial for matching the claim with the correct account.
3. Fill out the owners' address thoroughly, ensuring all information is accurate and up-to-date.
4. Record the date that the payment was made to the claimant or when the account was reactivated.
5. Input the total amount of reimbursement you are requesting, ensuring that this amount corresponds with your records.
6. Provide the account/reference number related to the claim. If this encompasses an aggregate claim, please specify accordingly.
7. Indicate the amount of the entire deposit in which the requested funds were contained.
8. Attach one of the required documents to this claim: either a copy of the cancelled replacement check (front and back), an account reactivation document, or the original travelers checks/money orders.
9. Enter the year reported for your claim to provide context for your request.
10. Have a notary public validate your claim by signing and sealing the form.
11. Type or print the name of the representative completing the form along with their signature and date.
12. Mail the completed form to the Kentucky Department of Treasury at the address provided in the document.
13. After reviewing all information for accuracy, save your changes, and choose to download, print, or share the document as necessary.

Complete your Holder Request For Reimbursement online today to ensure prompt processing.