Form Rpd-41203 - List Of Owners Of Unclaimed Stocks And Other Securities
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1RPD-41203
State of New Mexico - Taxation & Revenue Department
Rev. 03/2011
LIST OF OWNERS OF UNCLAIMED STOCKS AND OTHER SECURITIES
Page No._____ of ______
Report Year
Holder (Name of Business)
Federal ID Number
Address
Period Covered
From: ________________________
To: ____________________________
City
State
ZIP Code
(MM/DD/YY)
(MM/DD/YY)
Contact Name
Daytime Phone Number
E-mail Address
Number
Prop-
Owner Name
Social Security No.
Date of Last
Desription
Last Known Address
Owner
Issuer /
erty Type
of Shares
Transaction
of Securities
or Federal Tax ID
CUSIP No.
Class
Last
First
Middle
Number & Street
Code
No.
Code
City, State, ZIP
(1)
(5)
(6)
(7)
(8)
(2)
(4)
(9)
(3)
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Parent category: Financial