Form Ac2709 - Verification And Checklist For Unclaimed Property Page 2
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21.
ACCOUNT BALANCES
Dormancy
Cash
Shares
Period
A.
Demand Deposit Account(s)
3 yrs
1A.
$ ___________________
B.
Savings Accounts (includes Club Accounts, Security Deposits &
Retirement Accounts)
3 yrs
1B.
$ ___________________
C.
Time Deposit Accounts
3 yrs
1C.
$ ___________________
D.
Money on Deposits to Security Funds (if separate from A & B)
3 yrs
1D.
$ ___________________
E.
Unidentified Deposits (if separate from A & B) & Suspense Accounts
3 yrs
1E.
$ ___________________
F.
Escrow Funds (Mortgages, Performance Guarantee, Surety Bonds, etc.)
3 yrs
1F.
$ ___________________
G.
Credit Balances Arising from Loans (includes Liquidated Mortgages,
Consumer Loans, Remainder of Collateral Amounts, etc.)
3 yrs
1G.
$ ___________________
H.
Credit Balances; Consumer Credit Accounts
3 yrs
1H.
$ ___________________
I.
Credit Balances in Trading & Investment Accounts with Trusts, Brokers,
Investment Firms, etc. (Including O/S checks issued to customers)
3 yrs
1I.
$ ___________________
J.
Credit Balances or Cash Due Renters of Safe Deposit Boxes
3 yrs
1J.
$ ___________________
2.
NEGOTIABLE INSTRUMENTS
A.
Certified Checks
3 yrs
2A.
$ ___________________
B.
Cashier, Teller Checks
3 yrs
2B.
$ ___________________
C.
Bank Money Orders
3 yrs
2C.
$ ___________________
D.
Treasurer & Registered Checks
3 yrs
2D.
$ ___________________
Drafts & Bank Traveler’s Checks
E.
3 yrs
2E.
$ ___________________
F.
Warrants
3 yrs
2F.
$ ___________________
G.
Outstanding Checks Issued to Vendors (Accounts Payable)
3 yrs
2G.
$ ___________________
H.
Travelers Checks (non-bank)
15 yrs
2H.
$ ___________________
I.
Licensed Money Transmitter Receipts & Money Orders (non-bank)
5 yrs
2I.
$ ___________________
yr
2J.
$ ___________________
J
State Checks
1
3.
PAYING AGENTS, FIDUCIARY, MUTUAL FUNDS, AMERICAN DEPOSITORY
RECEIPT ACCOUNTS AND CORPORATION DISBURSING DIRECTLY TO THEIR OWN SHAREHOLDERS
A.
Cash Dividends (other than ADR)
3 yrs
3A.
$ ___________________
B.
Bond Interest (other than ADR)
3 yrs
3B.
$ ___________________
C.
Stock Dividends (other than ADR)
3 yrs
3C.
$ ___________________ 3P ______________
D.
Distributions from Ownership of Interest (other than ADR), includes \
Redemption Values, Warrants, Underlying & Unexchanged Shares &
Accrued Dividends
3 yrs
3D.
$ ___________________ 3Q ______________
E.
Cash Dividends (ADR)
3 yrs
3E.
$ ___________________
F.
Stock Dividends (ADR)
3 yrs
3F.
$ ___________________ 3R ______________
G.
Other Distributions Resulting From Ownership of Interest (ADR)
3 yrs
3G.
$ ___________________ 3S ______________
H.
Bond Redemption
3 yrs
3H.
$ ___________________ 3T ______________
I.
Mutual Fund & Dividend Reinvestment)
3 yrs
3I.
$ ___________________ 3U ______________
4.
INVESTMENTS, TRADING (BROKER/DEALER) AND BANK TRUST DEPARTMENT ACCOUNTS
REPRESENTING DISTRIBUTIONS RECEIVED FOR KNOWN AND UNKNOWN OWNERS
A.
Cash Over Receipts (Dividends & Other)
3 yrs
4A.
$ ___________________
B.
Bond Interest Over Receipts
3 yrs
4B.
$ ___________________
C.
Stock Over Receipts (Dividends & Other)
3 yrs
4C.
$ ___________________ 4P_______________
D.
Other Over Receipts
3 yrs
4D.
$ ___________________ 4Q ______________
E.
Unidentified Overages
3 yrs
4E.
$ ___________________ 4R ______________
F.
Other Distributions Resulting from Ownership Interest or Debt Obligation
3 yrs
4F.
$ ___________________ 4S ______________
5.
REFUNDS
A.
Utility Service Deposit
2 yrs
5A.
$ ___________________
B.
Advance Payments for Utility Services Not Furnished
2 yrs
5B.
$ ___________________
C.
Refunds Due on Overcharges by Utility Companies
2 yrs
5C.
$ ___________________
D.
Refunds Due by Insurance Companies
3 yrs
5D.
$ ___________________
E.
Amounts Due for Undelivered Goods and/or Services
3 yrs
5E.
$ ___________________
F.
Rebates
3 yrs
5F.
$ ___________________
6.
INSURANCE PROCEEDS
A.
Limiting Age (Superannuated) Contracts
N/A
6A.
$ ___________________
B.
Matured Endowments
3 yrs
6B.
$ ___________________
C.
Death Claims
3 yrs
6C.
$ ___________________
D.
Amounts Due Under Policies of Insurance Other than Life
3 yrs
6D.
$ ___________________
E.
Refunds & Other Amounts Due Under Policy Terms
3 yrs
6E.
$ ___________________
F.
Annuities
3 yrs
6F.
$ ___________________
G .
Retained Asset Accounts, Benefits Access Accounts or similar distribution
Accounts
3 yrs
6G.
$ ___________________
7.
FUNDS OWING BY COURTS AND GOVERNMENTAL UNITS
A.
Trust Funds
3 yrs
7A.
$ ___________________
B.
Bail Funds
3 yrs
7B.
$ ___________________
C.
Funds for Support of Spouse or Child
3 yrs
7C.
$ ___________________
D.
Condemnation Awards
3 yrs
7D.
$ ___________________
X.
Other
3 yrs
7X.
$ ___________________
8.
OTHER AMOUNTS AND SECURITIES
A.
Wages, Payroll, Salaries, Commissions, Pension Payments
3 yrs
8A.
$ ___________________
Unredeemed Gift Cards (5 yrs), merch. credits, lay-away deposits, AR and AP
B.
credits on cards (3 yrs)
3/5 yrs
8B.
$ ___________________
C.
Amounts Owed by Sales & Insurance Finance Companies
3 yrs
8C.
$ ___________________
D.
Surplus from Sale of Pledged Property
1 yr
8D.
$ ___________________
E.
Lost Property
3 yrs
8E.
$ ___________________
Securities Long in Customers’ Trading, Investment, Trust Accounts
F.
3 yrs
8F.
$ ___________________ 8P ______________
G.
Securities Held As Transfer Agent
3 yrs
8G.
$ ___________________ 8Q ______________
H.
Securities Held in a Vault or Storage Area of a Bank
3 yrs
8H.
$ ___________________ 8R ______________
I.
Securities Lost & held by a Safe Deposit Company or Bank
3 yrs
8I.
$ ___________________ 8S ______________
J.
Securities Found in a Safe Deposit Box
3 yrs
8J.
$ ___________________ 8T ______________
K.
Other Securities Owed
3 yrs
8K.
$ ___________________ 8U ______________
X.
Late Filing Interest
8X.
$ ___________________
Y.
Other Miscellaneous Property
3 yrs
8Y.
$ ___________________ 8Z ______________
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