Skip to main content

Arizona voters approved Proposition 207 (adult use marijuana) in the 2020 General Election. For more information, click here.

Customer Notice: Due to COVID-19, ADOR's in-person lobby services are by appointment only and in compliance with local municipal and county face covering policies.

 

taxes
Arizona
Department of Revenue
    • Home
    • Business
    • E-File Services
    • Forms
    • News & Notices
    • Reports, Statistics and Legal Research
    • Tax Credits
    • Transaction Privilege Tax (TPT)
    • View My 1099-G
    • Unclaimed Property
    • Contact Us
  • Home
  • Business
  • E-File Services
  • Forms
  • News & Notices
  • Reports, Statistics and Legal Research
  • Tax Credits
  • Transaction Privilege Tax (TPT)
  • View My 1099-G
  • Unclaimed Property
  • Contact Us
  • About
  • Contact Us
  • Site Map
  • Subscribe
  • facebook
  • twitter
  • linkedin
  • Home
  • Forms
  • Unclaimed Property Forms
  • Indemnity Agreement
  • Forms
    • TPT Forms
    • Bingo Forms
    • Collections Forms
    • Corporate Tax Forms
    • Tax Credits Forms
    • Estate Tax Forms
    • Fiduciary Forms
    • Exempt Organization Forms
    • Individual
    • Other Forms
    • License Compliance Forms
    • Liquor Forms
    • Partnership Forms
    • Power of Attorney (POA) / Disclosure Forms
    • Property Tax Forms
    • Tobacco Forms
    • Unclaimed Property Forms
    • Withholding Forms
    • GPLET Forms
    • Payment Vouchers
    • Forms Technical Information
    • Approved Tax Software Vendors
    • Booklet X
    • Information for Tax Preparers
    • Corporate Income Tax Highlights
    • Exempt Organization Tax Highlights
    • Individual Income Tax Highlights
    • Partnership Highlights
    • Withholding Highlights

Indemnity Agreement

Agreement to indemnify the State and hold it harmless against any and all claims, judgments, decrees, cost, expenses (including reasonable attorney fees) or any other loss which the State might sustain by reason of delivering or relinquishing said property to me and by reason of the State’s refusal hereafter to deliver said property or any part thereof to any other persons or entities.

Form Number: 
17-5521
Category: 
Unclaimed Property Forms
Form Year Form Published
Current PDF icon Download (28.76 KB) 01/01/2006
Arizona
Department of Revenue
  • Contact Us
    • Report an AZTaxes Issue
    • Report a Web Issue
    • FAQs
    • Locations and Services
    • Mailing Addresses
    • Customer Satisfaction Surveys
    • Report Tax Fraud
Arizona Department of Revenue
(602) 255-3381
1600 West Monroe Street
Phoenix, AZ 85007
  • facebook
  • twitter
  • linkedin
  • Subscribe for Updates
  • Site Map
    • Forms
    • Where's My Refund?
    • AZTaxes.gov
  • News & Notices
  • Report Tax Fraud
  • Privacy
  • Accessibility
  • Careers