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Dear Nebraskans,Thank you for your interest in the 2019Unclaimed Property Report. Unclaimedproperty can come in many differentshapes and sizes, from an uncashedpaycheck to an inactive bank account orsome other form of property that youmay have waiting for you.The 2019 Unclaimed Property Reportlists all of the properties received in thelast year of 25 or more. While this mayseem impressive, our website is evenmore comprehensive. So when you aredone looking through the pages of thispublication, I encourage you to visit ourwebsite which is continually updatedwith new names.In other words, I hope checking for yourname isn’t a one-time event for you oryour family. You could be missing out!If you find your name on these pages – oron our website – follow one of these easysteps to claim your money: Complete the claim form on thispage and mail it to the UnclaimedProperty Division, 809 P Street,Lincoln, NE 68508, making sure toprovide required documentation. Call the Unclaimed PropertyDivision at 402-471-8497 or toll freeat 1-877-572-9688. Find your name on the StateTreasurer’s website treasurer.nebraska.gov. Simply type yourname into one of the “Search forUnclaimed Property” fields on thehome page and click “submit claim”next to your name when you find itlisted. Stop by my office in room 2005 ofthe State Capitol or the UnclaimedProperty Division offices at 809 PStreet in Lincoln’s Haymarket.Good luck with your search. If you havesuccess in finding unclaimed propertyand would like to share your story withus, please feel free to contact my Directorof Communications at 402-471-2455. Iwould love to hear from you.Sincerely,John MuranteState TreasurerCLAIM TO STATE OF NEBRASKA FOR UNCLAIMED PROPERTYProperty ID Number(s) (if known):“Claimant” means person claiming property.“Owner” means name as listed with the State Treasurer.Claimant’s Name and Present Address:Claimant is:Original OwnerGuardian or CustodianExecutor, Administrator or Personal RepresentativeHeir(s) or Beneficiary of DecedentOtherHow did you become aware of this property?Unclaimed Property Newspaper PublicationNebraska State FairHusker Harvest DaysOther Outreach (list event):News Story (print/web/tv/radio)Advertisement (print/web/tv/radio)Facebook/Social MediaFriend or family memberOtherEmail Address:Daytime Telephone Number:Claimant’s Social Security or Federal Tax ID Number*:Owner’s Date of Birth:Name of Owner as it appeared during your search:Property by CountyADAMSHeir affidavit: Complete this portion of the form if you are claiming the property of a deceased person.I do hereby swear or affirm, under penalty of perjury, that I am serving as a fiduciary of the Estate ofwho died on theday of,.DayMonth,YearI am theof the decedent, and I assume responsibility to distribute lawfully this property, including withholding portions for payment ofall relevant estate and county inheritance taxes, to the following surviving heirs (list all names, relationships, addresses & phone numbers - Attach a separatesheet if necessary). Further, I will indemnify the State of Nebraska, its officers and employees, from any loss resulting from the payment of this claim.Heir Name, Address, and PhoneHeir Name, Address, and PhoneHeir Name, Address, and PhoneHeir Name, Address, and PhoneIf your claim includes shares of stock, your signature indicates that you swear or affirm under penalty of perjury that the stock certificates issued to the ownerhave been misplaced, destroyed, or were never received and that these certificates have never been sold, pledged, hypothecated, or otherwise transferred. If atany time in the future the certificates are located, you agree to surrender them immediately to the State of Nebraska.If my unclaimed property contains shares of stock, I authorize the State of Nebraska to (check one)Sell my shares and send me the proceeds (default)Transfer the shares into my name (only applicable if you are the original owner of the shares, not an heir)This claim form must be signed and notarized. Each undersigned claimant, being first duly sworn, deposes that, to the best of his/her knowledge, theundersigned is/are the owner(s), heir(s) or have a rightful interest in the said abandoned property being held by the Treasurer of the State of Nebraska. Eachclaimant also declares that all above information and attachments are true and complete documents. Further should any claim be made against the StateTreasurer regarding the said abandoned property and found to be of valid nature, the undersigned claimant(s) will reimburse the Office of the State Treasurer.If claiming for a business, this claim form must be signed by a partner of a partnership; an officer of a corporation (include a corporate resolution naming officerauthorized to sign); or an officer of an unincorporated association.Signature(s) of Claimant(s)Subscribed and sworn before me this20.day ofNotary PublicCounty, StateNotary stamp My Commission ExpiresYou must present valid ID for your claim to be processed.Attach documentary evidence that establishes the claimant as the rightful owner of the property. Include as much detail evidence as possible.PLEASE ATTACH EACH OF THE FOLLOWING:Photocopy of your valid Driver’s LicensePhotocopy or proof of your Social Security number*List of owner’s former addresses for last 10 yearsIf owner is deceased, photocopy of death certificate and proof of your right torepresent the estateReturn To:State Treasurer John Murante809 P StreetLincoln, NE 68508-1390Check here if you would be willing to be interviewed about your unclaimed property for possible publication by the State Treasurer’s Office.STATE TREASURER’S RECORD & RECOMMENDATIONWarrant Number:Amount:ApprovedDate of Warrant:Date Mailed:By:Claim Number:Date Filed:By:Denied*“Privacy Act of 1974 Disclosure: (1) the disclosure of your social security number on this form is voluntary; (2) it is solicited to aid the State Treasurer in determining whether you are entitled to claimunclaimed property; (3) your social security number will not be shared with any other 3rd party, with the exception of the Accounting Division of the Department of Administrative Services. If you object tothe disclosure of your social security number, we will attempt to use alternative means for verification purposes; however, your claim may be rejected.”2 STATE TREASURER JOHN MURANTE – UNCLAIMED PROPERTY REPORTReminder: Information concerning theamount or description of the property andthe name and address of the holder maybe obtained by any person possessing aninterest in the property by addressing aninquiry to the State Treasurer.ADAMS COUNTYIMPREST FUNDADAMS KAREN LADSIT MATTHEW JAGRICULTURALTECHNOLOGYCO INCAHL DONALDAKSAMIT JAMESALBERS GLENDAALLEN EMMANUELALLSMAN CORYALONSO YOENSYALPHA PHI OMEGAAMAYA JOSEAMAYAQUINTANILLA JOSE AAMLQUIST KERRYARLT NATHANARLT NICHOLAS JASMUS GINGERASMUS RICHARDATKINS MIKELAULNER RODNEYAUTO GLASS PROSBARBEE ALANBARRAZAFRANCISCOBARRY A BOHLENBARTH BEVERLY JBARTH GARY W MDBARTUNEKKATHLEENBEATTY CHAREE MBEATY BRETTBECKBY JAYBELL BRUCEBENKER LAVONNE LBENNETT RICHARDBIGLEY KIMBERLEYBINDERUP ROBERTBISHOP RICHARDBLACK BRUCE LBLANKBLANKENSHIPCHERYLBLOEM LOISBLUEHORSECOLLEENBOLD NEBRASKABONAHOOMJAMES NBONIFAS JASONBOURG JONATHANBOUTIN ELSIE TBOUTIN ELSIETHESSIEBOYD PAULINE DBOYER HEATHER NBOYKIN ANGELABOYKIN VICKI LYNBREUNIG BENBRIGHT RAYMONDBRISENO JOSEBROWN PAMELABRYAN JOEBUETTNER ABBY JBUSS MELISSACALLAWAY GLADYS ICAMPOS JAVIER ACAPAN LEVENTCARRILLO ELIASCASE EMILYCASTANEDARODRIGUEZ JESUSCASTELLONORLANDOCASTILLO ALVAREZJOSE FCASTILLO JOSECENTRAL NE HOMECARECHANCE COLLEENCHEYNEY DAWNCHILDREN &ADOLESCENTCLINICCHILDS MALISSACHOATE MELISSACHRISTHIANSENCYNTHIACHRISTIAN TYCOHEN JIMCOLBURNLAWRENCECONNER EVELYNCONNIE R HARTZELLPEPERCONOVER BELVA TONWOODFESTIVALCOX AMBERCRAIG ALINA BCURRENTDAROTHEADART KEITHAN LDART KEVIN LDAUGHERTY JESSIEDAVIS TANNERDETTWILLEREARLENE W.DIEKEN DOLORES LDIETZE PAULDOLFIN MICRODEVICESDONNA MURPHYDOWLING DORIS ADRESCHERCHRISTINE HDUERING MATTHEWDUERING ROGERDUFF BRANDONEARL ELIZABETHEBERHARDT ALEX REHMANN FRANCISELLIOT ROBERT ANDTABITAELTING JACOB DERNST ARDYCEEST OF NOLA 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EDUARDORICHARDS JOHNRICHARDSONCHARLES ERIESE DENNISRIVERA BEATRIZRIVERA JOSEROBLES SARAIRODRIGUEZKIRSTENROJEMANNNATHANIELRONALD E SMITHROSENBAUM JANETROY REENARYE DONALDSADD HAVOLD WSARGENT MARILYNSCHAFER DALE ESCHERBARTH INCSCHIRMER BRENT ISCHISON TAMMY LSCHMITZ EUGENESCHUKEI DARRELL ESCHURMANNBRIANSCHUTTE STEVENSEALEY DENNISSERRANO JOSESHELTON HEATHERSHREVE ELAINESHRIVER JAMESSISNEROZGUERRERO CMARIESKALKA IDA BSKINNER DORISSMITH HARRIETT LSMITH MARGERY MSNIVELY JOHN RSONDER ARCHIE ISOTO SOTEROSPADY CAROLYNSTALLINGS ERICACARDHOLDERSTEINSLAND VICKI ASTEMMERMANCATHERNESTORMS DAKOTA RSTORY LINDASTRATEGIC PIONEERSTREFF BRIANSTRICKLANDBEVERLY JSTRIPS SWEETSTROBL PATRICIASUNMART SOUTHSUTTER ROBERT ESUZANNEGREENQUIST DOSWENDROSKICYNTHIASWIFT NOAH SSYPHERD HELENTAYLOR TATIANATENJAYHERNANDEZ FELIPETHARP ROBERTTHEIS JOSEPHTHEIS JOSEPH RTHOMAS LANATHOMAS ROBERT LTHOMPSON MARK LTHORNTON KELLITODD TRENTON DTORSKE MICHAELTOVES GLORIA LTOWNS DENNISTR NATURALTRI STATE OILRECLAIMERS INCTROBAUGH 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JASONWOODARDNAUGHTIN EDWARDBENJAMINNELLEN METHAWRIGHT RANDEE RR & B FARMS INCZEMLICKA JAYDA RRANKIN GINAZEMLICKA KATHIEROAN AMYZEMLICKA KATHIE JSHANE NICOLE DEZEMLICKA KAYLEE JSIMMONSZEMLICKA ZACHARY CATHERINEZIEGENBEIN BILLSTULTZ STANLEYTERMAN BRYAN JTRUBE DEBRACROSS LAVAUGHN WELLS THOMASWIESER SUSIEBANNERANTELOPEBLAINEBOONEHART KENNETH RHENDRICKSONCOLIN EHENDRICKSONSARAH NHENZLER DEBRA JHENZLER RONALD LHICKS ROBERTHIGHFIELD WILLIAMHORN AMYHORSTMAN BRADYHORSTMAN KAYHUGHES JIMMIEHUNZIGER CINDYIMIG JUDYJ REED ANDREWJALYS STEAKHOUSEJELINEK JAMESJELINEK LAURIEJELINEK TRUCKINGJESPERSENBARBARAJESSE LESTERJESSE VIRGINIAJESUS ANTONIOJOHNSON JOANNEJONES DAVID PJONES DONALDJUNGCK KATHRYNKILPATRICK ANNKILPATRICK C FJTWROSKNAUB CASEYKOCH H FREDRICKKOCH MARGARET CKRAMER KRISTINAKREB MONTELACHMAN LAURALEAVELLE TAMMY ALEE DENNIS ELEE ELIZABETH MLEHL SUE LLINDBURG MARK ALISA L HAASLOEBIG JAMESLOOMIS CHERYLLOPEZ MISAELLORE SUSANLUBE EXPRESSCENTERLURZ TRAVISMAGDALENO JOHNP SRMARSH CMARSH C JMARTINEZ DIANA KMAZANEC MILDREDMCBRIDE DAVIDMCCAIN LANNIEMCDONALD MARYMCQUISTONJUDITHMCQUISTONJUDITH PMCQUISTONMICHAELMEYER BAYONE KMONTEMAYORADRIAN EMOORE DEBRA SMOORE KEVINF MR.MULHERN LINDA JMUNGER TIMOTHYMUNRO ALLEN WMURPHY SHIRLEY MMYERS MICHAELNEMECHEKANISSA KNEMECHEKJAY-DEE RNEWLIN CARLOSNEWMAN STEPHENORR KIRKOSBORN RONALD RPACHAK CHERRIPARIS BRIANAPARRA JAVIERPETERS MIAH DPETERSEN MARTY APETERSEN SHERRI LPRELLE DANIELLEPROCHAZKA IRENEPROCHAZKATABITHA JPRZYMUS DEERAMOS PRIMITIVOIIIRASNIC LYLEREICHART TESREYNOLDS RYANRICE JEFFRISING STARCONSTRUCRJ CORMANROBB KATIEROBB TEDROCK MARY CROWLAND DANSALAZAR EUFEMIOSANCHEZ LUIS FSCHEFCIKBARBARITASCHUMACHERJUSTIN MSCOTT JOHNSHANNON JIM DSHELLEY PAULASHERLOCK BRYANSHERLOCKCASSANDRASHERLOCK SUSANSHORES BRIAN JSLAGLE DSMITH ROGERSTANDAGE TEDDY LSTEELE DEREKSTEELE SAMMISTEINKE AMANDA PSTOLL ENNONSTONE ASHLEYSTOUT MARYSTRANGS CARPETSTRICKER JOY JSTROTHKAMPAARONSULLIVANMCKENNASWANSON MATHEWSZENASI CYLVIATAYLORHERDT LIZTHOMAS BURDETTETOMS AUTO & CYCLEREPAIRTOOLEY MICHAEL JTSCHACHEI KONI JVANKERREBROOKDANWALKER BRIANWEBSTER SARAHWEEKES JOSEPH MWEEKES MARGARETWELLS TODDMURRAYWICKHAM CAROLWINTERS SEAN PBOYDBILL LECHTENBERGBOETTCHERMARTIN EBOSKA GARRONCATHERINE MILLEROR JAKOB MILLERCLASSEN FARMSINCCLASSEN NEILCONKLIN KENT DERBST AUDREYERBST AUDREY GERLENBUSCH LILEGONZALES PHILLIPGORANSON STUARTHANSEN ROBERT SRHAUN CATHY AKALLHOFF BRADLUBER KELSYMITCHELL ALICENEWSAM JUDYREISER BRIAN LSCHUMANNRONNIESUTHERLANDSHELLY RWENDELL DENNISWICKERSHAMZACHARYBROWNALBER SHARI JBARKER BRUCEBRODBECK TROYBUDDE CONRAD JRBUNCH TIMOTHYCHRISTENSENJEROMYCOBB CHEVY OLDSCOLE LISACOZAD JOHNDAILEY SETHFERGUSONMICHAELFLING JERODGAMBILL TAYLORHARTHOORN BARRYHASKELL DAVID HClaims Paid in 2018ARTHUROVER 100,000 50,000 - 99,999 10,000 - 49,999 1,000 - 9,999UNDER 1,00014 CLAIMS20 CLAIMS182 CLAIMS1,259 CLAIMS15,466 CLAIMSSTATE TREASURER JOHN MURANTE – UNCLAIMED PROPERTY REPORT 3

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