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New Jersey Unclaimed Property Claim Inquiry Form UP-10 / 08-15 Send Completed Forms to either State of New Jersey Unclaimed Property Administration P. O. Box 214 Trenton NJ 08625-0214 ATTN Claim Section OR upadocs treas. nj. gov Form Definitions Reported Property Owner The person who may have financial assets being safeguarded by the UPA. New Jersey Unclaimed Property Claim Inquiry Form UP-10 / 08-15 Send Completed Forms to either State of New Jersey Unclaimed Property Administration P. O. Box 214 Trenton NJ 08625-0214 ATTN Claim Section OR upadocs treas. nj. gov Form Definitions Reported Property Owner The person who may have financial assets being safeguarded by the UPA. Claimant The person completing this form and submitting a claim to recover financial assets. Name First Last SSN Previous Addresses possibly linked to Financial Assets Street Address City State Zip Claimant Information Phone E-mail Owner Relation Select One I am the reported property owner. The reported property owner is deceased I have the legal capacity to represent their estate. By signing this document I certify that the following statements made by me are true. I have the legal authority to place a claim on the property listed above. To have the legal authority to file a claim on the property listed above the claimant must be either the Reported Property Owner or possess the legal authority to place a claim on behalf of the Reported Property Owner Court appointed Power of Attorney Estate Administrator Legal Heir Corporate Officer etc*. I am aware that if any of the foregoing statements made by me are willingly false I am subject to punishment. O. Box 214 Trenton NJ 08625-0214 ATTN Claim Section OR upadocs treas. nj. gov Form Definitions Reported Property Owner The person who may have financial assets being safeguarded by the UPA. Claimant The person completing this form and submitting a claim to recover financial assets. Name First Last SSN Previous Addresses possibly linked to Financial Assets Street Address City State Zip Claimant Information Phone E-mail Owner Relation Select One I am the reported property owner. Claimant The person completing this form and submitting a claim to recover financial assets. Name First Last SSN Previous Addresses possibly linked to Financial Assets Street Address City State Zip Claimant Information Phone E-mail Owner Relation Select One I am the reported property owner. The reported property owner is deceased I have the legal capacity to represent their estate. By signing this document I certify that the following statements made by me are true. The reported property owner is deceased I have the legal capacity to represent their estate. By signing this document I certify that the following statements made by me are true. I have the legal authority to place a claim on the property listed above. To have the legal authority to file a claim on the property listed above the claimant must be either the Reported Property Owner or possess the legal authority to place a claim on behalf of the Reported Property Owner Court appointed Power of Attorney Estate Administrator Legal Heir Corporate Officer etc*.

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