Form Up 8-9 - Security Report Of Unclaimed Property
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1West Virginia State Treasurer
Security Report of Unclaimed Property
Form UP 8-9
FEIN/SSN:
Holder Name:
Item number
1. Stock Property Type Code:
2. Trading Symbol:
/
/
3. CUSIP:
4. Date of Last Activity:
,
.
5. Remitted number of shares:
6. Remitted Security name:
7. Trading Name of Security:
,
,
.
8. Cash Property Type Code:
9. Cash remitted:
-
-
/
/
10.Owner SSN:
11. Date of Birth:
12. Ownership:
Primary Owner
And
Or
Other
13. Owner Name Last, First, MI:
____________
14. Address: __________________________ ___________ 15. City: ____________
-
16. State
17. Zip Code
18. Additional Owner Name Fast, First, MI:
19. Address: __________________________ ___________ 20. City: _________________________
-
21. State
22. Zip Code
Item number
1. Stock Property Type Code:
2. Trading Symbol:
/
/
3. CUSIP:
4. Date of Last Activity:
,
.
5. Remitted number of shares:
6. Remitted Security name:
7. Trading Name of Security:
,
,
.
8. Cash Property Type Code:
9. Cash remitted:
-
-
/
/
10. Owner SSN:
11. Date of Birth:
12. Ownership:
Primary Owner
And
Or
Other
13. Owner Name Last, First, MI:
____________
14. Address: __________________________ ___________ 15. City: ____________
-
16. State
17. Zip Code
18. Additional Owner Name Fast, First, MI:
19. Address: __________________________ ___________ 20. City: _________________________
-
Page
of
21. State
22. Zip Code
Page total $
,
,
.
If last page, enter grand total remitted $
,
,
.
15
Revised 8/20/09
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Parent category: Business