Form Ap- 2 - Report Of Abandoned And Unclaimed Property
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REPORT OF ABANDONED AND UNCLAIMED PROPERTY
AP- 2
TREASURY USE ONLY
Receipt Number ___________________
Robert M. McCord
Receipt Date ______________________
Treasurer
Amount __________________________
Number Shares ____________________
HOLDER NAME
EIN #
REPORTING YEAR
PROPERTY DESCRIPTION
ACCOUNT NUMBER
OWNER EIN NUMBER
OR
OWNER SOCIAL SECURITY NUMBER (Optional)
BUSINESS NAME/OWNER NAME
(FIRST NAME, MI, LAST NAME)
STREET ADDRESS
CITY
STATE
ZIP CODE
AMOUNT REPORTED AS DUE OWNER
NUMBER OF SHARES
ISSUE DATE
CHECK NUMBER
CERTIFICATE NUMBER
LAST ACTIVITY DATE
CUSIP NUMBER
ORIGINAL ISSUE NAME
PAGE
OF
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Parent category: Financial