Fill and Sign the Unclaimed Property Claim Form Ampampamp Checklist Comptroller of

PROPERTY INFORMATION CHECKLIST SALES10 Gen era l I n fo rm atio nP ro perty l o cati o n:_ _______ ______________________ _____________________________________________T ype o f p ro perty :_ _______ ___________________________________________________________________O wner:_ _______________ ____________________________________________________________________A ddre ss o f O w ner:_ ______ ___________________________________________________________________T ele p ho ne:_ ____________ ____________________________________________________________________O ccu pan ts :_ ____________ ____________________________________________________________________L ease t e rm s:_ ___________ ______________________ _____________________________________________B U IL D IN G:A ge:_ __ _____________ B uild er:_ ____________________________ S ty le :_ ___________________________ _E xte rio r:_ ___ ___________ ____________________In te rio r:_ _________________________________________F oundatio n:_ ____________ ______________ R oof:_ __ _________________ S to rie s:_ ____________________ _N o. o f r o om s:_ _ R oom s iz e :1 ___________ 2 ___________ 3 ___________ 4 ___________ 5 _______________ __G ara g e:_ ___________ S to ra g e a re as:_ _____________ P orc h es, b alc o nie s:_ ______________________________B ase m en t:_ _____________ _ C arp ort:_ _____________ __ V ie w :_ ______________________________________S ew er:_ ____ S ep tic t a n k:_ _ ___ H eatin g A /C :_ ________ _ G as:_ _________ E le ctr ic ity :_ ____________________W ate r heate r:_ __________________ Lig htin g:_ ________________ ___ Garb ag e:_ ______________ ____________C O NTEN TS a n d U TIL IT IE S:Fir e p la ce:_ __ ___________ _________ S to ve:_ ________ O ven :_ ________ D is h w ash er:_ ____________________G arb ag e d is p osa l:_ _______ S in ks:_ ________ C ab in ets :_ _________ C lo se ts :_ ________S helv es:_ ____________S ta ll s h ow ers :_ ________ B ath tu bs:_ _________ T oile ts :_ _________ C arp ets :_ __________ B ar:_ ___________ _F ix tu re s:_ ___ ___________ _______ W ash er a n d d ry er:_ _____________________________________________L A ND o r L O T:Siz e:_ _______ __________ ___________ T erra in :_ ____ ___________ F ro nta g e:_ ________________________ _C orn er:_ _______________ ___________ P ed estr ia n t r a ffic :_ ________ A uto m obile t r a ffic :_ _______________ __S id ew alk s:_ _____________ __ D riv ew ay :_ ___________ _C urb a p peal:_ ___________ L aw n:_ ______________ _T re es:_ ______ _______ S prin kle rs :_ _____________ P ool:_ ___________ P atio :_ __________________________Y ard :_ _ ________________ _____________________ F en ce:_ ________________________________________G EN ER A L A REA :N am e o f a re a:_ ___________ _________________________________ Z onin g:_ _________________________ _C ro ss s tr e ets :_ ____________ ________________________ S ch ools :_ __________________________________P ark s:_ ______ __________ ________________________ B an ks:_ ______________________________________S hoppin g c en te rs :_ _______ ____________________________________________________________________S to re s:_ _____ ___________ _________________________________________________________________ __ _R esta u ra n ts :_ __ ___________ __________________________________________________________________In sp ecte d a n d v erif ie d o n t h is _ ____ d ay o f _ ______________________________________, 1 99___.In sp ecto r_ ___ ___________ ___________________________________ S elle r_ ______ ___________ ____________________________________