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Case 8:07-bk-10687-CPM Doc 86 Filed 05/28/13 Page 1 of 4

UNITED STATES BANKRUPTCY COURT

MIDDLE DISTRICT OF FLORIDA, TAMPA DIVISION

RE:

Leathel S. Davis

Debtor(s)

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Judge - Catherine Peek McEwen

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Case No. 8:07-bk-10687-CPM 3v1c:
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MOTION FOR PAYMENT OF UNCLAIMED FUNDS

Dilks & Knopik, LLC, attorney-in-fact for Leathel S. Davis, Claimant, hereby petitions the Court
for $3,902.62, which is the sum of all monies being held in the Registry of the Clerk, United
States Bankruptcy Court, as unclaimed funds, which are due to, Leathel S. Davis, debtor.

The debtor did not receive the dividend check in the above case for the following reason:

The original dividend check was sent to a Leathel S. Davis at PO Box 726, Palmetto, FL 34220.
That address is no longer valid. The current address is listed below. The change in mailing
address may have prevented the original dividend check from being cashed.

The claimant's current mailing address is:

Leathel S. Davis
Attn: Leathel S. Davis
707 59th Ave
Bradenton, FL 34203
443-875-5770
Last Four Digits of SSNITIN: 8377

Dilks & Knopik, LLC now seeks to recover the funds from the Court's Registry. Wherefore,
Dilks & Knopik, LLC prays that the Court order that a check in the amount of $3,902.62 made
payable to Leathel S. Davis c/o Dilks & Knopik, LLC, 35308 SE Center Street, 35308 SE Center
Street be issued form the Courts Registry.

Date: May 21,2013 1 Dilks

rian & J. Dilks Knopik, LLC

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35308 SE Center Street
Snoqualmie, WA 98065

ribed to, before me

for State of Washington, County of King
Commission Expires: August 9.2015

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Case 8:07-bk-10687-CPM Doc 86 Filed 05/28/13 Page 2 of 4

Case 8:07-bk-10687-CPM Doc 86 Filed 05/28/13 Page 3 of 4

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Returr~ Ma11 Operabans
PO BOX 744 1 1
Des Mornes. /A 50306-3411

For informational pumoses

JACKIE LEONARD DAVIS
LEATHEL S DAVIS
P 0.BOX 726
PALMETTO, FL 34220-0726

Summary

JON M. WAAGE
CHAPTER 13 TRUSTEE
P. 0. Box 25001
Bradenton, FL 34206-500 1

RETURN SERVICE

REQUESTED

Statement date
Loan n u m b e r
Property address
707 59TH TER E
BRADENTON FL 34203
Customer Service 4 O n i ~ n e
,..-. 'to'? Telephone

kellsfnlgo corn

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1-800-274-7025

Hours of operation
Mon - Frl '7 a m . - 8 p m

Correspondence
PO Box 10335
Des Mc~nes. :A 50305

- O Payments
?O Box 660455
Dallas 'TX 75266

Important messages
This statement is for informational purposes on
Our records indicate that your loan is subject tc
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07- 10687-CPM
Leathel S. Davis
P.O. Box 726
Palmetto, FL 34220-0726

Proof of Addreu

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From: B~ian Eaguhn

Fax: 14251 836-5718

Case 8:07-bk-10687-CPM Doc 86 Filed 05/28/13 Page 4 of 4

To: [email protected]~c Far: +1941751?M3

Page 5 of 5 5/141?013 155

Subs;tul; w.9 1

1

(Rev 1.1- 2009)
( Name (as shown on your inwrns tax d m )
Leathel S. Davis
Business name, If different from above

Request for Taxpayer

Identification Nr~mber and Certification

I [XJ lndl~ldu8l~Sol~ Proprietor
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LLC filing aa Disregarded
Entity /Sole Proprietor

I rJ Atlmey

U Medlcal U Regular

O_tl~ filing as a Corporation

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Attorney

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Address (number, slreet, and apt. or sulte no.)
707 59th Ave
Cily, state, and ZIP mde
Bradenton, FL, 34203
List account [email protected]) hem (optional)

I Give form to the

requester. Do not
/ send to the IRS.

1

1

Exempt from
backup
withholding

Requester's name and address (optional)

Taxpayer Identification Number (TIN)

Enter yow TIN in the appropriate box. The TIN provided must match the name given on Line 1 to avoid backup withholding.
For individuals, this is your social security number (SSN). However, for a resident alien, sole proprietor, or disregarded entity.
set the Part I instructions on pnge 3. For other entities, it is your employer identification number (EIN). If you do not have a
number, see How lo get a TIN on page 3.

Note: If the account is in more than one name, see the chart on page 3 for guidelines on whose number
to enter.

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2)617+914+813)717

or

1

Under penalties of peljury. I certify that:
The number shown on this form is my correct taxpayer ldentlflcalion number (or I am walting for a number to be Issued to me), and
I am not subject to backup wlthholdlng because: (a) I am exempt from backup wlthholdlng, or (b) I have not been notifled by the Internal Revenue Service
(IRS) that I am subject to backup withholding as a reault of a fallure to report all interest or dividends, or (c) the IRS has notifled me that I am no longer
subject to backup withholding, and
I am a U.S. person (including a U.S. resident alien).
Certlffcation instructions. You must cross out item 2 above If you have been notifled by the IRS that you are currently subject to backup withholding
because you have failed to report all interesl and dividends on your tax return. For real estate transactions, item 2 does not apply.

.

For mortgage interest paid, acquisilion or abandonment of secured property, cancellation of debt, wntributlons to an individual retirement arrangement
(IRA), and generally, payments other than interest and dlvidends, you are not required to sign the Certlcation, but you must
provide your correct TIN. (See the Instructions on page 3.)
Sign

(,J&,~x

Date

Signature of
U.S. person

General Instructions
Section references are to the Internal Revenue Code unless otherwise noted.

Purpose of Form
A person who is required to file an infonation return with the IRS must obtain your correct taxpayer idenliflcation number (TIN) to report, for
example, income paid to you, real estate transadions. mortgage interest you paM, acqulsltion or abandonmenl of secured property.
cancellation of debt, or contributions you made to an IRA.

Use Form W-9 only if you are a U.S. person (Indudlng a resident alien), to provide your correct TIN to the person requesting it (the

requester) and. when applicable, to:
1. Certify that the TIN you are glvlng Is correct (or you are waiting for a number to be issued),
2.Certify that you are not subject to backup withholding, or
3.claim exemption from backup withholding if you ares U.S. exempt payee. If applicable, you are also certifying that as a U.S. person, your
allocable share of any partnership income tom a U.S. trade or business is not subject to the withholding tax on forei~n oartners' share of
effectively connectedincome.
Note. If a requester gives you a form other than Form W-9 to request your TIN, you must use the requester's form If it is substantially
similar to this Form W-9.

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