pioneer connect unclaimed capital credits online claim form Unclaimed Capital Credits Pioneer Connect Unclaimed Capital Credits Claim Form Once received, Pioneer Connect will validate your claim. Your claim will be processed within 30 days and a check will be mailed to the current mailing address entered below. Thank you! Member's Name * Member's Name First First Last Last Member's Account Number Service Address When Member Had Service With Pioneer Service Address When Member Had Service With Pioneer Service Address When Member Had Service With Pioneer Service Address When Member Had Service With Pioneer City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Approximate Years Member Had Service With Pioneer From To Your Name * Your Name First First Last Last Current Daytime Phone Number * Your Current Mailing Address * Your Current Mailing Address Your Current Mailing Address Your Current Mailing Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Your Email Address Relationship to Deceased if Claiming for an Estate Note: Attach copy of death certificate & notarized copy of member's will, trust, or small estate affidavit which states the heir(s) entitled to claim the member’s account. Your Signature * Clear Please upload the following:• Driver’s License or Legal ID* (Required)• Copy of death certificate & notarized copy of member's will or small estate affidavit which states the heir(s) entitled to claim the member’s account. (If Applicable) UPLOAD HERE (REQUIRED) * Drop a file here or click to upload Choose File Maximum upload size: 12MB Additional documentation may be requested by Pioneer Connect to complete verification. If you are human, leave this field blank. Submit
