Post #3736

Pursuant to California Government Code Section 50052, I wish to file a claim for a previously unclaimed check in the amount of:(Required)
That was published in the Ventura County Courier on:(Required)
The grounds on which I file this claim are:(Required)
Vendor or Individual Name (Printed):(Required)
Taxpayer I.D. or Social Security No.:(Required)
Telephone Number:(Required)
Email:(Required)
Address:(Required)
City/State/Zip Code:(Required)
Proof of Identity:(Required)
Accepted file types: jpg, png, pdf, Max. file size: 10 MB.
Vendor or Individual Name (Signature):(Required)