Form Mow 3011-1.1 - Motion For Payment Of Unclaimed Funds From Court Registry printable pdf download

Form Mow 3011-1.1 - Motion For Payment Of Unclaimed Funds From Court Registry

MOW 3011-1.1 (10/2014)

UNITED STATES BANKRUPTCY COURT

WESTERN DISTRICT OF MISSOURI

In Re:

)

Case No.

Debtor(s)

)

MOTION FOR PAYMENT OF UNCLAIMED FUNDS FROM COURT REGISTRY

Comes now (movant's name, address, telephone number:)

represented by _________________________, requests that the court enter an Order for Payment of

Unclaimed Funds, and in support of the motion, states:

A check in the amount of $______________ belonging to (name of original

creditor/claimant)_______________________________________________ was tendered to the

Clerk of Bankruptcy Court by the case trustee as unclaimed funds.

The amount stated is being held in the Treasury of the United States as unclaimed funds. Movant is

entitled to receive the requested funds based upon (check all that apply):

□

Movant is the owner of said funds being the owner appearing on the records of this Court.

□

Movant is the assignee of the owner of the claim to said funds, as evidenced in the attached

Affidavit or Assignment or Right.

□

Movant is the owner's successor in interest, as evidenced in the attached Affidavit and/or other

identifying documents.

□

Movant is the personal representative of the owner's estate, as evidenced in the attached

Affidavit and/or other identifying documents.

□

Movant is named in a LIMITED POWER OF ATTORNEY by (grantor)

__________________________, as evidenced in the attached Power of Attorney document

that empowers the movant to collect the unclaimed funds described above on behalf of the

grantor:

□ As the owner of the claim.

□ As the owner's attorney at law, with authorization to receive said funds.

□ As the assignee of the owner's claim to said funds.

□ As the owner's successor in interest.

□ As the personal representative of the owner’s estate.

□

Other (describe)__________________________________________________________

_______________________________________________________________________

The following documents are submitted, as proof of the movant's identity and status as the owner of

claim of entitlement:

□ Power of Attorney

□ Formal Assignment

□ Letter of Appointment

□ Court Order

□ Completed IRS Form W9 or AO Form 213 (Vendor / TIN Certification) (Required)

□ Other (describe) _________________________________________________

Form Mow 3011-1.1 - Motion For Payment Of Unclaimed Funds From Court Registry

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