Individual Safe Deposit Box Inventory Form - Office Of The State Treasurer Kansas
Download a blank fillable Individual Safe Deposit Box Inventory Form - Office Of The State Treasurer Kansas in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Individual Safe Deposit Box Inventory Form - Office Of The State Treasurer Kansas with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Print Form
Office of the State Treasurer
Individual Safe Deposit Box Inventory
Lynn Jenkins, CPA
Page _____ of ______
Unclaimed Property
900 SW Jackson St Ste 201
Business Name ___________________________________________________
Topeka, Ks 66612-1235
Fed. Emp. I.D. #___________________________________ Report Year ______________
This form must be included with each individual SDB reported.
SDB Number
Amount Due Holder
Date of Abandonment
Owner Name 1 (Last First & Middle Name)
Social Security No.
Branch Where Property Was Held
Relation
Code
Owner Name 2 (Last First & Middle Name)
Social Security No.
Branch Name
Mailing Address
Street or PO Box
-
City
State
Zip Code
City
State
Zip
Please check box if these items are included in SDB.
Stock Certificates
List # of Bonds for each
(list each certificate individually)
A count or itemized description is not needed for these items.
denomation.
Vital Statistics
Savings Bonds
# of Shares
Stock Name
Birth Certificates
at
$
Death Certificates
Stock Name
# of Shares
$
at
Marriage Certificates
$
# of Shares
Stock Name
at
Legal Documents/Aggrements
$
at
# of Shares
Stock Name
Last Will & Testaments
The list below contains categories of SDB contents that require itemized descriptions. Check the box(es) if this SDB contains any of the
Divorce Degrees
following categories. Please list the individual items on a Item Detail Form (see page 19).
Adoption Papers
Collections
(Stamps/Spoons/Sports Cards/Etc.)
Medals
Other
Abstracts/Agreements/Deeds/Property Titles
Rare/Unique
(Diaries/Books/Silver/Etc.)
Rare/Unique Coins(
Mortgages
Books/Sets/Currency)
Weapons (
Misc.
Except Guns)
Car Titles
(Keys/Pens/Cameras/Souvenirs/Tokens)
Coins
Currency
Other Documents
(Please remove wrappers/tubes from all coins.)
Total # of Pennies
Total # of $1.00
Life Insurance Policies
Income Tax Records/Receipts
Total # of $2.00
Total # of Nickels
Bank Statements/Canceled Checks/Etc.
Total # of Dimes
Total # of $5.00
Investments
Total # of Quarters
Total # of $10.00
Military Records
Total # of 1/2 Dollars
Total # of $20.00
SSN Records
Total # of Dollars
Total # of $50.00
Personal Papers
Total # of $100.00
Total # of Foreign Coins
Letters/Postcards/School Info./Licenses
Total # of Foreign
Total # of Unidentifiable
Media
*Do not include Rare/Unique coins & currency in the totals above.
Rare/Unique Coins (Books/Sets/
Photos/Negatives/Cassettes/Video/Disketts
Currency) must be listed individually on a Item Detail Form (see page19.)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal