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Get Claim For Warrant Canceled One Year After Date Of Issuance

2. 3. 4. 5. Read the "Notice to Claimant" section prior to completing the form. Complete the requested information in the "Claimant Information" section of the form. Complete the requested information in the "Claim Information" section of the form. Have the claim statement notarized. Return the completed form to: Division of Accounts and Reports Central Services Team 900 SW Jackson, Room 351-S Topeka, KS 66612-1248 Telephone No. (785) 296-2925 NOTE: ITEMS 2, 3 AND 4 MUST BE COMPLETED IN ENTIR.

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