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PUBLIC NOTICE PUBLIC NOTICE PUBLIC NOTICE PUBLIC NOTICE NOTICE IS HEARBY GIVEN THAT, the Chief Financial Of ficer of the City of Huntington Beach, County of Orange, State of California, decla res that the following monetary sums have been held by the Chief Financial Officer and h ave remained unclaimed in the funds hereafter indicated for a period of over three (3) years and will become the property of the City of Huntington Beach on the 28th day of February, 2023 at 6:00PM28th day of February, 2023 at 6:00PM28th day of February, 2023 at 6:00PM28th day of February, 2023 at 6:00PM , a date not less than forty-five (45) days nor more than sixty (60) days after first publication of this Notice.
Any party of interest may, prior to the date design ated herein above, file a claim with the Chief Financial Officer which includes the claimant ’s name, address, amount of claim, the grounds on which the claim is founded and the date, name, amount, and heading shown in this notice. The Chief Financial Officer may accept or reject the claim. If rejected by the Chief Financial Officer, the party submitting the c laim may, within 30 days of receiving a notice of rejection, file and serve on the Chief Fi nancial Officer a verified complaint seeking to recover all, or a designated part, of the unclai med funds. Claim forms are available at:
www.huntingtonbeachca.gov/UnclaimedFunds.
Published/glyph250Huntington/glyph250Beach/glyph250Wave/glyph250Jan./glyph2505,/glyph25012,/glyph2502023
CLAIM FORM - UNCLAIMED FUNDS
Original Payee Name:
Claimant Name: ________________________________________ Phone #: _________________________ (if different)
Current Address:
DL#: SS#/TIN: Phone #:
(Individuals: please attach a copy of your driver’s license) Address when check was written:
Reason for original check issue (if known):
Original Check: Date: Amount:
In consideration thereof, it is agreed that the undersigned, the heirs, executors, successors or assigns of the undersigned, will indemnify and hold harmless the City of Huntington Beach, or as signs, from and against any a nd all claims, liability, loss, damage, expenses, counsel fees and costs arising through or by reason of any endorsement, presentation, negotiation, collection or any attempt at collection or negotiation of the Original Check or the Replacement Check by the undersigned, the employees, or agents of the undersigned. In the event the Original check shall be found, the undersigned agrees to deliver to cause the same to be delivered to the City of Huntington Beach for cancellation and to reimburse the City of Huntington Beach for all expenses incurred by reason of the issuance of the Replacement Check.
Authorized Signature: ________________________________________ Date: _________________________ Name (Print): ______________________________________ Title: __________________________________ Please mail back to: City of Huntington Beach
Attn: Finance Department – Unclaimed Funds
P.O. Box 190
Huntington Beach, CA 92648-0190
CITY OF HUNTINGTON BEACH
FINANCE DEPARTMENT
P.O. BOX 190
HUNTINGTON BEACH, CALIFORNIA 92648-0190
TELEPHONE: (714) 536-5200 FAX: (714) 536-5934
www.huntingtonbeachca.gov/unclaimedfunds
City of Huntington Beach Use Only
Finance
Confirmed item on outstanding check list Name/Date: __________________ Check if O/S at bank ______________________________________ Input & Processed claim Name/Date: ________________________________ Void check at bank _______________________________________ Replacement Check: Check # _________________ Check Date: __________ Authorize reissue of check _________________________________ In order to process a replacement check and claim these funds, the City of Huntington Beach Chief Financial Officer must receive this form