abandonedproperty

Abandoned or Unclaimed Property Bond

Call us at 800-921-1008 with any questions

Applicant Information

Applicants Name

% of ownership

Social Security #

Residence Address

State

Married Single

Phone Number

Email

Additional Partner?

Yes No

Partner #1 (Co-Applicant)

% of ownership

Social Security #

Residence Address

State

Additional Partner?

Yes No

Partner #2 (Co-Applicant)

% of ownership

Social Security #

Residence Address

State

Additional Partner?

Yes No

Partner #3 (Co-Applicant)

% of ownership

Social Security #

Residence Address

State

Business Information

Business Name / DBA

Legal Structure

Business Address

State

Business Phone #

Occupation or business

How long so engaged?

Previous surety?

Yes No

Give name of prevoius surety and reason for change

Select Bond Amount

Effective Date

Complete Name of Obligee (If Known)

Address of Obligee (If known)

State

Secure upload of relevant documents (i.e. Court order)

PDF files preferred

Additional Information & Comments

Bernard Fleischer & Sons Inc. • 29 Broadway, Suite 1511, New York, NY 10006 • 800-921-1008 • www.BFBond.com