Form 53-117 - Holder Claim Form Supplement
Download a blank fillable Form 53-117 - Holder Claim Form Supplement in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 53-117 - Holder Claim Form Supplement with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1Comptroller of
Public Accounts
Form 53-117
(Rev. 7-01/1)
TEXAS UNCLAIMED PROPERTY
HOLDER CLAIM FORM SUPPLEMENT
(to be used with the Holder Refund Request Form or the Holder Reimbursement Request Form)
HOLDER INFORMATION
Holder Name:
Tax ID Number:
PROPERTY INFORMATION
Report Year:
Report Amount:
Property Type:
Aggregate:
Property Amount:
Claim Amount:
No. of Shares:
Yes
No
Owner Name as Indicated on Report:
Owner Address:
Property Description:
PROPERTY INFORMATION
Report Year:
Report Amount:
Property Type:
Aggregate:
Property Amount:
Claim Amount:
No. of Shares:
Yes
No
Owner Name as Indicated on Report:
Owner Address:
Property Description:
PROPERTY INFORMATION
Report Year:
Report Amount:
Property Type:
Aggregate:
Property Amount:
Claim Amount:
No. of Shares:
Yes
No
Owner Name as Indicated on Report:
Owner Address:
Property Description:
PROPERTY INFORMATION
Report Year:
Report Amount:
Property Type:
Aggregate:
Property Amount:
Claim Amount:
No. of Shares:
Yes
No
Owner Name as Indicated on Report:
Owner Address:
Property Description:
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial