Michigan Department of Treasury                                                                                    Reset Form
3433 (Rev. 09-21) 
Unclaimed Property Inquiry 
Issued under authority of Public Act 29 of 1995. 
Read the instructions on page 2 before completing this form. 
PART 1:  CLAIMANT/PROPERTY OWNER INFORMATION 
Property Owner’s Name (include current and all former names)          Property Owner’s Social Security or Federal Employer Identification Number       

Claimant Name                       Relationship to Property Owner    Claimant’s Social Security or Federal Employer Identification Number (if different)      

Current Address (Number and Street)                                                       Property Number(s) 

City, State, ZIP code                                                                     Daytime Telephone Number 

E-mail Address 

PART 2:  FORMER ADDRESSES. List ALL former Michigan addresses used by the property owner. Attach a separate list, if necessary. 
                                Street Address                                            City, State, ZIP Code 

PART 3:  DECEASED PROPERTY OWNER. Refer to instructions for list of required documentation. 
1. Did the Decedent have a Will?                             Yes   No 
2. Did the Decedent have a Trust?                            Yes   No 2b. Is the Trust open?                 Yes     No 
3. Did the Decedent have a Probated Estate?                  Yes   No 3b. Is Probated Estate open?           Yes     No 
PART 4:  CLAIMANT CERTIFICATION 
Under penalties of perjury, I certify that the information provided on this inquiry form is true to the best of my knowledge.  Upon payment 
of this claim, said claimant will indemnify and hold harmless the State of Michigan, officers and employees from any damages, claims 
or losses of any kind resulting in payment of the property being claimed. 
SUBSCRIBED AND SWORN TO BEFORE ME THIS                                                 SIGNATURE(S) OF CLAIMANT(S) 

     DAY OF                                         , 20 

NOTARY PUBLIC                                    COUNTY, STATE 

MY COMMISSION EXPIRES 
Return completed form along with a copy of a picture identification, social security card, and required documentation (see page 2) to: 

Michigan Department of Treasury                                                           www.michigan.gov/unclaimedproperty 
Unclaimed Property 
P.O. Box 30756                                                                         Any additional properties that may belong to
Lansing, MI  48909                                                                        you will be added to your claim.

Allow 120 days for processing. 
                                                                 Office Use Only       
Approvals:            1.                         2.                3.                  4.          5. 

3433, Page 2 
                                                                Instructions for Form 3433, 
                                                                Unclaimed Property Inquiry 

FORM INSTRUCTIONS                                                                                 Documentation required:       
                                                                                                  1.  Did decedent have a Will?   
Part 1.    Complete applicable fields.      
                                                                                                          If yes, provide copy of Will.       
Part 2.    List ALL       former Michigan addresses used by the                                   2.  Did decedent have a Trust? 
property owner, including P.O. Boxes.                                                                     If yes, provide a copy of the Trust.       
Part 3.    If property owner is deceased, answer all questions                                            Is the Trust open? 
and provide required documentation.                                                                       If yes, the Trustee is entitled to claim the property 
Part 4.    Sign in front of a Notary Public and have form                                                 on behalf of the Trust, the Trustee will need to        
notarized.                                                                                                complete this form.       
                                                                                                  3. If the decedent had a Probated Estate 
              REQUIRED DOCUMENTATION                                                                  Provide the following:       
                                                                                                            •  If open, send a current copy (dated within last 
                                                                                                          12 months) of your Letters of Authority issued by 
Individual Property Owner                                                                                 the probate court certifying your appointment.       
                                                                                                            •  If closed, send a copy of the initial application/                                         
Submit copies       of the following documents (originals will 
                                                                                                          opening petition for Probate and the Testimony to 
not be returned): 
                                                                                                          Identity Heirs.       
   •   Picture ID (driver’s license or identification card)      
                                                                                                            •  A list of current addresses of all heirs.       
•          Social Security card. Alternatively, you may provide a 
                                                                                                  Business Property Owner 
       W-2, 1099, health insurance card, or other government-
       issued tax document                  verifying your complete Social                        
                                                                                                  Submit copies of the following documents:       
       Security number. 
         • If your name differs from how it appears on the Unclaimed                                 • Business card       
       Property Web site, submit legal documentation supporting                                      • Articles of Incorporation or DBA                   showing ownership 
       the name change (e.g. marriage certificate, adoption                                            of the business and name changes.       
       papers, divorce decree, etc.).                                                                • List of subsidiaries that entity can claim on behalf of.       
                                                                                                     • Documentation        showing        authorization for        you       to                act        
Claimant Other Than Property Owner                                                                     on behalf of the business entity shown as the original 
                                                                                                       property owner. 
Submit copies of the following documents:       
Parent on Behalf of a Minor                                                                       Closed (But Not Sold) Entities 
   •   Parent’s       picture     ID (driver’s license       or identification card)                 • Final Federal tax return filed including Schedule K       

   •   The minor child’s birth certificate and social security card.                              Sold Entities 
                                                                                                     • Buy/sell agreement showing who owned the accounts 
Guardian, Conservator, Trustee or Legal                                                                                                           
                                                                                                       receivable at the close of sale.
Representative 
•      Claimant’s picture ID                                                                      Dissolved Entities 
•      Property owner’s picture ID and social security card                                          • Dissolution papers and/or the automatic dissolution                                              
•      Court documents or other signed legal documents giving                                          papers and a copy of the final corporate Federal tax     
you authority to act on the property owner’s behalf.                                                   return, including Schedule K.       
                                                                                                     • List of current addresses of all shareholders.       
Deceased Property Owner 
                                                                                                  You may also be required to complete a formal                                                     
All questions in Part 3 must be answered in order to process        
                                                                                                  claim form and provide additional documentation. 
your inquiry. All claims        on behalf of deceased owners        must        
include the following documentation (originals  will not be  
returned):                                                                                        Allow 120 days for processing from the date form was 
                                                                                                  mailed. 
   •  Copy of Death Certificate       
   •  Proof  of  your  relationship  to  decedent  (birth 
       certificate, marriage license)