Owner's InformationOwner's Information Current informationCurrent name (if different from above) Current street address or P.O. box(Required) Current city/town(Required) Current state(Required)ALAKASAZARCACOCTDEDCFLGAGUHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDMPOHOKORPAPRRISCSDTNTXUTVTVAVIWAWVWIWYCurrent Zipcode(Required)Current Telephone Number(Required)Email Address(Required) For identity purposes, please provide the last 4 digits of the member's Social Security number(Required)Service Address If the Unclaimed Funds owner is or was a SMECO customer-member, please provide the service address and dates of service. (Not applicable for payments to vendors or donations to organizations.) Address(Required)Service Dates(Required) Other Service AddressOther Service Dates For deceased membersIs the member deceased?(Required) Yes No Name of Personal Representative Mailing AddressPlease Include P.O. Box if applicableDaytime Telephone NumberRepresentative's Email Address Relationship to Deceased Date of Death MM slash DD slash YYYY Note: An original Letter of Administration and Death Certificate will be required. Copies will not be accepted.Claimant’s information (if different from above)Claimant's Name Claimant's Mailing Addressplease include P.O. Box if applicableClaimant's Telephone NumberAdditional Information