Business Affidavit

If the owner is a Business/Agency/Institution:

  1. Copy the format below onto the letterhead of your company, complete the information, and return to our office.
  2. If there is no company letterhead, use this affidavit format and attach a photocopy of your business license, or other documentation identifying your business as a legal entity.

NOTE: All affidavit(s) must be accompanied by the signed and dated claim form(s).

Re: Unclaimed Property Reference No.: _____________________________________

I, _______________________________, hereby affirm that I am employed
                  (Print or type name)

by, or that I am an officer of __________________________________________
                                                              (Print or type name of business)

and I am duly authorized to claim such funds as may be held by the state of Idaho.

In the event a superior claim is received and honored by the state of Idaho’s Unclaimed Property Program of the Idaho State Tax Commission, I will hold harmless the payer of the claim, and will return such funds as received under this claim.

___________________________________      _______________________________
                       (Signature)                                                           (Title held)

Subscribed and sworn to before me this _____ day of ____________, _____.

__________________________________
                (Notary’s signature)

Notary in and for the state of: ______________________________

My Commission expires: _________________________________

 

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