Refund Form

To request a refund, complete the Holder Request for Reimbursement form at the link below. Along with your notarized form, please include an explanation with documentation of why the refund is being requested. For example, the original check has been cashed, the account remitted has been reinstated, or the account was remitted in error. If the original check was cashed or the account reinstated, please provide documentation.

Return the refund form and your documentation to the address below:

Nebraska State Treasurer’s Office
Unclaimed Property Division
809 P Street
Lincoln, NE 68508