Abandoned Property Notification

Date

Customer Name

Address:

Attention:___________

Dear _____________:

Our records indicate funds in the amount of ____________ are due to your company.  These funds are the result of unused credit memos and/or unapplied payments. Supporting documentation is attached.  Please request via mail or email, a refund of these funds.  The request must be signed by an authorized employee of your company.

Please complete bottom section legibly.  Return via mail or email.  To avoid unclaimed funds going to the State of ________, your response must be received no later than_________. 

Please contact me with any questions at _____________.

Best Regards,

Name and Title