Ipnr- Ifb (E) - Final Report On Unclaimed Amounts - 2003
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1Commonwealth of Puerto Rico
Office of the Commissioner of Financial Institutions
Unclaimed Property Division
PO Box 11855 San Juan Puerto Rico 00910-3855
FINAL REPORT ON UNCLAIMED AMOUNTS
AS OF JUNE 30, 200
(Required from reporting institutions subject to Section 37(a) of Act No. 55 of 1933, as amended.)
December 10
Filing deadline:
Name of Reporting Company
Taxpayer Identification No.
Holder No.
Contact person
email address:
Telephone :
(
)
-
ext.
Fax (
)
-
Business Address
Postal Address
(if different)
I hereby CERTIFY that Unclaimed Amounts in the sum of $
held by this institution
as of November 30, 200 are being transferred to the OCFI, as required by Section 37(a) of Act
No. 55 of 1933.* A check to the order of the Secretary of the Treasury for said amount and a hard
copy of the
Unclaimed Amounts
Addendum to the Final Report on
as of June 30 (Form IPNR- IFBA (E))
accompanies the original of this report. (The electronic filing of the Addendum is also
required from
a NAUPA format software, is available for downloading at
holders reporting 25 or more records. HRS,
, or on CDROM, directly from the OCFI, free of charge.)
Name of person filing report
Title
Date filed
/ /
(dd/mm/yyyy)
Signature _______________________________________
This report may be filed by mail
Corporate
or by fax to (787) 723-4225.
Stamp
* Unclaimed property as of June 30, net of amounts returned to owners and advertising expense.
2003
IPNR- IFB (E), revised in October,
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