February 11, 2019 CLAIM FORM

Claim ID: 5198294

BRENDA J HERRING
423 E ANNIE AVE
COEUR D ALENE, ID 83814-3532

Please refer to the Documentation Required section and follow the Final Instructions at the bottom of the form.
Claimant Information
Name(s): BRENDA J HERRING Phone: (209) 649-9803

Current Address: 423 E ANNIE AVE, COEUR D ALENE, ID

Email Address: Bren4Life@live.com Date of Birth: 07/19/1966

Relationship to Original Owner: Individual SSN/FEIN: Provided

How did you find out that your name was on Idaho's Unclaimed Property list?

Relative/Friend X Internet Newspaper Television Special Event

Would you like to donate 100% of your claim proceeds to one of the following funds?

General Fund Public School Veteran's Cemetery Fund Parks & Rec Fund

Property Information
Owner Company / Security Name Type of Property Property ID Value

HERRING BRENDA CK01: CASHIER'S

BANK OF AMERICA NA - IDAHO 1760863 Greater than $100.00
UNKNOWN UNKNOWN 00000 CHECKS

BRENDA J, HERRING MS01: WAGES,

QUALFON DATA SERVICES GROUP 3056870 $50.00 - $100.00
PAYROLL, SALARIES

Stock Information
Not Applicable

Documentation Required
Photo ID w/
Signature
Proof of address
reported by holder
Original checks
Proof of Claimant
Address
Provide a copy of your photo ID with your signature. This must be a
government issued ID.
Provide proof of living at or receiving mail at the address shown with the
property.
Send in the original check.
Provide proof of current address.

Idaho Unclaimed Property a Division of the Office of The State Treasurer

P.O. Box 83720 Boise, ID 83720-9101 PH: (208) 332-2942
Web: YourMoney.idaho.gov
 Claim ID: 5198294
Affidavit
I declare that I have examined this form and accompanying documents and, to the best of my knowledge and belief, they
are true, correct and complete.

Signature of Claimant Date

2nd Claimant Signature (Joint Accounts) Date

Final Instructions
If additional documentation is required (see Documentation Required section) and send to our office within 30 days.

• You may upload the claim form and documentation on our website YourMoney.Idaho.Gov
OR
• Mail the documentation to our office at the address listed below:
Idaho Unclaimed Property
PO Box 83720 • Boise ID 83720-9101
304 N. 8th St, Suite 208 • Boise ID 83702-9101

If you have any questions or concerns contact us at (208) 332-2942 • Toll-free (877) 388-2942

Idaho Unclaimed Property a Division of the Office of The State Treasurer

P.O. Box 83720 Boise, ID 83720-9101 PH: (208) 332-2942
Web: YourMoney.idaho.gov