COUNTY OF ________________
Before me, the undersigned authority, personally appeared ____________________________________
(attorney in fact/”Affiant”) who swore or affirmed that:
- Affiant is the Claimant in the Finder Contract executed by and between them and __________________________(hereinafter “Finder”) on ____________________date.
- The Finder has explained to Affiant the law on unclaimed properties, and that unclaimed property due to Affiant may be claimed without a fee, free and simple.
[signature of Affiant]
State of Kentucky
County of ___________
The foregoing instrument was acknowledged before me this ______ day of _______ (year), by ______________________ (name of person acknowledged).
(Signature of person taking acknowledgment)
(Title or Rank):__________________________
(Serial number, if any):____________________
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