Get Holder Reimbursement Request - Nc Treasurer

This guide provides a comprehensive overview of how to accurately complete the Holder Reimbursement Request form from the North Carolina Treasurer's Office. By following these steps, users will ensure their requests for reimbursement are properly submitted.

Follow the steps to complete the Holder Reimbursement Request form.

1. Click ‘Get Form’ button to access the Holder Reimbursement Request form and open it for editing.
2. In the Holder Information section, fill in your name, Holder ID, address, FIN, city, state, zip code, contact name, and phone number. This information identifies who is requesting the reimbursement.
3. In the Report Information section, specify the total amount of the report and the date it was reported. List the reported owner's name and address, along with the reported owner amount. If applicable, include the aggregate amount if property was reported in an aggregate format.
4. Move to the Claimant/Owner Information section. Enter the date the claimant paid or the account was reactivated, the amount paid to the claimant, as well as their current name and address.
5. In the Required Holder Documentary Evidence section, provide a detailed list of the documentary evidence from the Holder's records, demonstrating the payment or account reactivation. Include documents like a cancelled check or other proof of payment.
6. Complete the Certifications section by having two principal officers of the Holder or one principal officer and an authorized employee sign and notarize the form. Ensure all necessary information is accurate and true.
7. Once all sections are completed, save the changes. You may download, print, or share the form as needed for submission.

Complete your Holder Reimbursement Request form online to ensure a smooth reimbursement process.