Amnesty Agreement

              (www.cashdash.net)
AMNESTY AGREEMENT
BETWEEN
THE ILLINOIS STATE TREASURER’S OFFICE
UNCLAIMED PROPERTY DIVISION
AND
_____________________________________ (HOLDER)
This Agreement is made and entered into this _____ day of _________________, 2005, by and
between the Illinois State Treasurer’s Office, (the “Treasurer”) and the
________________________________________ (the “Holder”).
RECITALS
WHEREAS, ____________________________________________________________
(Describe Holder, e.g., a U.S. Corporation, Incorporated in __________________(state))
WHEREAS, the Holder is voluntarily notifying the Treasurer of its potential liability under the
Illinois Uniform Disposition of Unclaimed Property Act (the “Act”); and
WHEREAS, the Holder is not currently under examination nor, to its knowledge, has it been
notified by the Treasurer, or by anyone acting on behalf of the Treasurer, of the Treasurer’s intention to
conduct an unclaimed property examination of the Holder;
WHEREAS, because of the Holder’s voluntary disclosure, the Treasurer may derive property
that, otherwise, might have gone unreported;
NOW, THEREFORE, the Treasurer and the Holder hereby agree as follows:
1. The foregoing recitals are hereby incorporated herein and made an express part of this
Agreement.
2. The Holder and the Treasurer agree that the Treasurer may conduct an examination of the
Holder’s books and records to determine the Holder’s unclaimed property obligations for
fourteen (14) years to present (the “Examination Period”), or date of incorporation,
whichever is older.
3. In the event that the report contains 10 or more owners, Holder will be required to submit
the remittance in an electronic format approved by the Illinois State Treasurer’s Unclaimed