Instructions for Filing an Application for Payment of Unclaimed Dividends

Revised: 
Thursday, November 30, 2023
UNITED STATES BANKRUPTCY COURT
Northern District of California
 
Instructions for Filing an Application for Payment
of Unclaimed Dividends
(Also referred to as Unclaimed Funds)
 
A complete and notarized Application for Payment of Unclaimed Funds (form attached below), with supporting documents as stated below and a Certificate of Service must be filed with the Court.  A separate Application is required for each requested unclaimed funds payment.
 
Supporting Documents
(Required for All Applications)
A copy of the applicable “Notice of Unclaimed Dividend” on file in the bankruptcy case is the initial document necessary to process a filed Application.   
 
Notice of Unclaimed Dividend Filed Before January 2005:
Generally, a Notice of Unclaimed Dividend filed before January 2005 is available only in paper form.  When a Notice of Unclaimed Dividend is in paper form the Applicant must provide a copy of the Notice of Unclaimed Dividend with the Application.
 
Case documents available only in paper form may be physically stored at the Court or off-site from the Court at a Federal Records Center (FRC).  To obtain a paper copy of a Notice of Unclaimed Dividend follow the Copy Request Procedure located at this link: http://www.canb.uscourts.gov/procedure/district/copy-request-procedure.  A document search fee and a record retrieval fee may apply.
 
Case documents in paper form physically stored at the FRC for more than 15 years are thereafter transferred to the National Archives and Record Administration (NARA) for retention or disposal.  To determine if copies of documents transferred to NARA are available, contact NARA directly at http://www.archives.gov/research/court-records/.
 
Notice of Unclaimed Dividend Filed January 2005 and After:
A Notice of Unclaimed Dividend filed January 2005 and after does not need to be provided with an Application.  Instead, the Court will download a copy of the Notice of Unclaimed Dividend from the CM/ECF electronic records maintained for the applicable bankruptcy case.
 
Domestic Claimant: *
A Domestic Claimant must provide a completed and signed W-9 form certifying the Domestic Claimant’s tax identification number. 
 
Foreign Claimant: 
A Foreign Claimant must provide a completed and signed W-8 certification form and a completed and signed AO-215 form.
 
Additional Required Supporting Documents
(Required Per the Type of Claimant)
The party to whom the unclaimed funds were originally owed is the Owner of Record (also known as the original payee).  The Claimant is the party presently entitled to the unclaimed funds.  The Applicant is the party filing the Application.  The Applicant, Owner of Record and the Claimant may be the same person or entity.
 
Sufficient unredacted documentation must be provided to establish a Claimant’s identity and entitlement to unclaimed funds.  If there are joint Claimants, supporting documentation must be provided for each Claimant. Required additional supporting documentation varies depending on the type of claimant, and whether the Claimant is represented. 
 
Owner of Record
When the Claimant is the Owner of Record (originally owed the funds), the following documentation is required:
 
Owner of Record as Claimant (Individual or Sole Proprietor)
  • Proof of identity of the Individual or Sole Proprietor (for example, an unredacted copy of a driver’s license, other state-issued identification card or a United States passport that includes a current address).
  • Legible copies of documents that support the Individual or Sole Proprietor receiving mail at the address indicated in the “Notice of Unclaimed Dividend.”
  • Legible copies of documents that support the Individual or Sole Proprietor receiving mail at their current address.
  • Original or a copy of a business card of the Individual or Sole Proprietor, if available.
  • If the Individual or Sole Proprietor does not sign the Applicant Declaration located in section 6 of the Application, a separate notarized document signed and dated by the Individual or Sole Proprietor declaring under penalty of perjury that the application and supporting documents are true and correct must be provided.
Owner of Record as Claimant (Corporation, Partnership, LLC or Government Entity)
  • The Applicant Declaration located in section 6 of the Application must be signed and dated by an authorized representative for and on behalf of the business or government entity.  An authorized representative may be an employee of the business or government entity.
  • A notarized statement on the business or government entity’s letterhead (as applicable) signed by a government official or the business entity’s general partner, president, vice president, secretary, or director stating 1) the signing business or government official has the official capacity to assign the responsibility for requesting the unclaimed funds to an authorized representative, and 2) the authorized representative signing the Application has the capacity to act on the behalf of the business or government entity to request and collect the unclaimed funds.
  • Original or a copy of a business card of the authorized representative, if available.
  • Proof of identity of the authorized representative (for example, an unredacted copy of a driver’s license, other state-issued identification card or a United States passport that includes a current address).
  • Legible copies of documents that support the business or government entity receiving mail at the address indicated in the “Notice of Unclaimed Dividend.”
  • Legible copies of documents that support the business or government entity receiving mail at its current address.
Note: For all Owner of Record Claimants: If the Owner of Record’s name has changed since the unclaimed funds were deposited with the Court, proof of the name change must be provided.
 
Successor Claimant
A Successor Claimant may be entitled to the unclaimed funds as a result of an assignment, purchase, merger or an acquisition of the claim by other means.  When the  Claimant is a successor to the claim, the following documentation is required:
 
Successor Claimant (Individual or Sole Proprietor)
  • Proof of identity of the Successor Claimant (for example, an unredacted copy of a driver’s license, other state-issued identification card or a United States passport that includes a current address).
  • Legible copies of documents that support the Successor Claimant receiving mail at their current address.
  • If the Successor Claimant does not sign the Applicant Declaration located in section 6 of the Application, a separate notarized document signed and dated by the Successor Claimant declaring under penalty of perjury that the Application and supporting documents are true and correct must be provided.
  • Documentation sufficient to establish the chain of ownership or transfer of the claim from the original Owner of Record to the successor Claimant.
  • When a claim is acquired from an original Owner of Record, provide 1) proof of Identity of the original Owner of Record (for example, an unredacted copy of a driver’s license, other state-issued identification card, a United States passport that includes a current address or an employee identification card), and 2) legible copies of documents that support the Original Owner of Record receiving mail at the address indicated in the “Notice of Unclaimed Dividend” (for example, documents to show receiving mail at the address indicated in the “Notice of Unclaimed Dividend” include a utility bill and a bank statement).
     
    NOTE: A Successor Claimant entitled to unclaimed funds by transfer, assignment, purchase, merger, acquisition, or succession by other means, must serve a copy of the completed Application and all supporting documents by mail to the Owner of Record and all other previous owner(s) of the claim at their current address, or provide a statement explaining why the Successor Claimant was not able to do so or an explanation of why doing so is not necessary.
Successor Claimant (Corporation, Partnership, LLC or Government Entity)
  • The Applicant Declaration located in section 6 of the Application must be signed and dated by an authorized representative for and on behalf of the Successor Claimant business or government entity.  An authorized representative may be an employee of the business or government entity.
  • A notarized statement on the business or government entity’s letterhead (as applicable) signed by a government official or the business entity’s general partner, president, vice president, secretary, or director stating 1) the signing business or government official has the official capacity to assign the responsibility for requesting the unclaimed funds to an authorized representative, and 2) the authorized representative signing the Application has the capacity to act on the behalf of the business or government entity to request and collect the unclaimed funds.
  • Original or a copy of a business card of the authorized representative, if available.
  • Proof of identity of the authorized representative (for example, an unredacted copy of a driver’s license, other state-issued identification card or a United States passport that includes a current address).
  • Legible copies of documents that support the Successor Claimant entity receiving mail at its current address.
  • Documentation sufficient to establish chain of ownership or transfer of the claim from the original Owner of Record to the Successor Claimant business or government entity.
  • When a claim is acquired from an original Owner of Record, provide 1) proof of Identity of the original Owner of Record (for example, an unredacted copy of a driver’s license, other state-issued identification card, a United States passport that includes a current address or an employee identification card), and 2) legible copies of documents that support the Original Owner of Record receiving mail at the address indicated in the “Notice of Unclaimed Dividend” (for example, documents to show receiving mail at the address indicated in the “Notice of Unclaimed Dividend” include a utility bill and a bank statement).
     
    NOTE: A Successor Claimant entitled to unclaimed funds by transfer, assignment, purchase, merger, acquisition, or succession by other means, must serve a copy of the completed Application and all supporting documents by mail to the Owner of Record and all other previous owner(s) of the claim at their current address, or provide a statement explaining why the Successor Claimant was not able to do so or an explanation of why doing so is not necessary.
Deceased Claimant's Estate
  • Certified copy of the decedent’s death certificate.
  • Proof of identity of the decedent’s estate representative (for example, an unredacted copy of a driver’s license, other state-issued identification card or a United States passport that includes a current address).
  • Copies of state court documents (certified) or other documents authorizing the decedent’s estate representative to act on behalf of the decedent’s estate in accordance with applicable state law.
  • If the decedent’s estate representative does not sign the Applicant Declaration located in section 6 of the Application, a separate notarized document signed and dated by the decedent’s estate representative declaring under penalty of perjury that the Application and supporting documents are true and correct must be provided.
  • Documentation sufficient to establish the decedent’s identity and entitlement to the funds, such as the documents required to show the identity and entitlement to the funds for the type of claimant (Owner of Record or Successor Claimant) stated above.
Claimant Representative
If the Applicant is an attorney, funds locator or another representative for a Claimant, the following documentation is required:
 
  • A dated, notarized and unexpired limited power of attorney signed by the Claimant (or by the Claimant’s legally appointed guardian, conservator, corporate officer or similar person) authorizing the Claimant Representative to act on behalf of the Claimant to request and collect the unclaimed funds.
  • Proof of identity of both the Claimant and of the Claimant Representative (for example, an unredacted copy of a driver’s license, other state-issued identification card or a United States passport that includes a current address).
  • Original or a copy of a business card of the Claimant Representative, if available.
  • Legible copies of documents that support the Claimant receiving mail at the address indicated in the filed "Notice of Unclaimed Dividends." 
  • Original or a copy of a business card of the Claimant, if available.
  • Documentation sufficient to establish the Claimant’s entitlement to the funds, such as the additional supporting documents required to show the entitlement to the funds for the type of claimant (Owner of Record or Successor Claimant) stated above.
Payment of Unclaimed Funds
Unclaimed funds are made payable solely to the established Claimant(s), except when the Claimant(s) provides a fully signed, dated, notarized and unexpired limited power of attorney authorizing payment of the unclaimed funds be made jointly to the Claimant and another person or entity (such as a funds locator).  Separate payments will not be made to split out a fee or commission, or to multiple Claimants individually.
 
Filing and Service of the Application,
Providing a Completed Proposed Order,
Original Ink Signatures Required
Hand Signed Original Ink Signatures - All signatures appearing on an Application, notarization, Certificate of Service, declaration, a form W-9, W-8, AO-215, an assignment of claim, a power of attorney and any other document drafted in support of an Application must be original signatures hand signed in ink.  Electronic signatures and signature copies are not accepted.
 
File a completed paper Application along with unredacted supporting documents (including a completed W-9 for a Domestic Claimant, or a W-8 and an AO-215 for a Foreign Claimant), a Certificate of Service and a completed proposed Order Granting Application for Payment of Unclaimed Funds (form attached below) by mailing to:
 
United States Bankruptcy Court
Office of the Clerk
450 Golden Gate Avenue
Mail Box 36099
San Francisco, CA 94102
Attention: Unclaimed Funds
Important:  The payee name entered on line one of a submitted W-9 form, on line one of a submitted W-8 form, and in the payee field on a submitted AO-215 form, must exactly match the name entered on the “pay to the order of” line on the submitted Order Granting Application for Payment of Unclaimed Funds.
Serve a copy of the completed Application and all supporting documents by mail to the United States Attorney for the Northern District of California, 450 Golden Gate Avenue, P.O. Box 36055, San Francisco, CA 94102.
If the Claimant is a Successor Claimant entitled to unclaimed funds by transfer, assignment, purchase, merger, acquisition, or succession by other means, the Successor Claimant must also serve a copy of the completed Application and all supporting documents by mail to the Owner of Record and all other previous owner(s) of the claim at their current address, or provide a statement explaining why the Successor Claimant was not able to do so or an explanation of why doing so is not necessary.
Note: A form Certificate of Service is included with the Application for Payment of Unclaimed Funds (attached below).
 
Court Fees
No fee is due to file an Application for Payment of Unclaimed Funds.
 
Generally, it is not necessary to reopen a closed case to file and process an Application for unclaimed funds.  If it becomes necessary to reopen a closed case solely to process an Application for unclaimed funds, a reopening fee is not charged.  A Transfer of Claim fee is due when a claim to unclaimed funds is transferred from a person or entity to another.
 
A fee is due for all requests for the Court to search, retrieve, copy or certify documents.  Additional information concerning current Court Fees is available at this link: http://www.canb.uscourts.gov/court-info/fees.
 
Post-Filing Process
To expedite processing an Application be sure to submit all required documents and any other documents that support the Application. 
 
If an Application is deficient the Court may send the Applicant a Notice of Deficiencies in an Application for Unclaimed Dividends, providing 30 days to cure the deficiencies. Thereafter, if all of the noticed deficiencies are not timely cured and received by the Court, the Court may send the Applicant a Notice of Failure to Cure Deficiencies in an Application for Unclaimed Dividends, notifying the Application is deemed withdrawn and the Court will take no further action.  A new Application must then be filed to start a new review process.
 
Important Additional Information
  • In addition to the supporting documentation listed above, Court staff may require other documents so as to verify the validity of the claim for unclaimed funds.
  • Examples of documents to show proof of identity include an unredacted copy of a driver’s license, other state-issued identification card or a United States passport that includes a current address.
  • Examples of documents to show receiving mail at a particular address include a utility bill and a bank statement.
  • If the name or address of the Owner of Record is misspelled or is otherwise incorrect on the “Notice of Unclaimed Dividend,” provide a document briefly explaining the misspelling and showing the correct spelling or address.  End the document with a penalty of perjury statement (I certify, under the penalty of perjury, under the laws of the United States of America, that the foregoing is true and correct), and sign and date the document.
  • A limited power of attorney MUST be notarized and unexpired and must include the debtor's name, case number, dollar amount of the unclaimed funds to be collected, the Claimant's signature and date the document was signed.
  • Affix a corporate seal to supporting documents, where applicable.
  • When claiming on behalf of a dissolved, purchased, merged or otherwise acquired business, examples of documents to support showing a chain of ownership of the claim to the present Claimant include:
► Any verifiable documents showing the business entity (or entities) that previously owned the right to claim the unclaimed funds is no longer operational,
 
► Any verifiable documents showing acquisition of the right to claim the unclaimed funds from the previous owner (such as a purchase or sale agreement), and
 
► Any other document showing a succession of the original claim.
 
  • To communicate facts or circumstances that would only be known by the Claimant, submit a declaration containing a penalty of perjury statement, signed and dated by the Claimant.
  • Court employees may not provide legal advice.
 

* A Domestic Claimant includes a United States citizen, a United States resident alien, a partnership, corporation, company or association created or organized in the United States or under the laws of the United States, an estate (other than a foreign estate), and a domestic trust (as defined in 26 C.F.R. 301.7701-7).