Report Of Unclaimed Securities Form
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1Report of Unclaimed Securities
REGISTRATION: “CHEDDAR & CO” (SECURITIES) OR “MAC & CO” (MUTUAL FUNDS)
S TAT E O F W I S C O N S I N • O F F I C E O F T H E S TAT E T R E A S U R E R
Mail to: Unclaimed Property Unit, Office of the State Treasurer, PO Box 2114, Madison WI 53701-2114
A
B
C
Holder Name:
FEIN#:
Report Year:
D
CUSIP#:
E
Issue:
Page __________ of __________
F1
F2
F3
F4
F5
F6
Property Code
Account Number
Owner’s Name and Last Known Address
Social Security #
Last Activity Date
Remitted Shares
G
Page TOTAL
H
Report TOTAL
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Parent category: Legal