Step 2: Fill out the form.
If your name was listed on the previous page, you may begin the process of claiming these funds by filling out the form below.
Please do NOT fill out this form if your name was not listed.
OFFICE HOURS
Monday – Friday
7:30 a.m. – 4:00 p.m.
Local: 225.922.0600
Toll-free: 800.256.3000
Fax: 225.935.2856
LOCATION
STREET ADDRESS:
8401 United Plaza Boulevard, 1st Floor
Baton Rouge, LA 70809
MAILING ADDRESS:
P.O. Box 44213
Baton Rouge, LA 70804-4213