Form Up-1 - Report Of Unclailmed Property Verification And Checklist
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1
2Government of the District of Columbia
Office of Finance and Treasury
REPORT OF UNCLAILMED PROPERTY VERIFICATION AND CHECKLIST
Name of Business (Holder)
Report Year ________
Street Address
___ ___ ___ ___ ___ ___ ___ ___ ___
City
State
Zip Code
Enter Your Federal Tax Identification Number
Every person, corporation, cooperative, or other business association, banking or financial organization, life insurance corporation, utility, court or public authority must complete the
following checklist before filing their District of Columbia Unclaimed Property Report. This list includes by way of illustration, but not limitation, those items which are covered by the District of
Columbia Uniformed Disposition of Unclaimed Property Act of 1980.
Please complete the checklist by indicating "Yes" or "No" by each item. Each item marked "Yes" should be enumerated on Unclaimed Property Form UP-2.
ACCOUNT BALANCES (Dormancy 3 yrs.)
YES
NO
YES
NO
_____
_____
A. Checking Accounts
_____
_____
F. Outstanding payroll checks (Dormancy 1 yr.)
_____
_____
B. Savings Accounts
_____
_____
G. Credit checks or memos
_____
_____
C. Matured certificates of deposit or savings certificates
_____
_____
H. Payments for good and services
_____
_____
D. Christmas Club accounts
_____
_____
I. Customer overpayments
_____
_____
E. Matured certificates of deposit or savings certificates
_____
_____
J. Unidentified remittance
_____
_____
F. Money on deposit to secure funds
_____
_____
K. Unidentified remittance
_____
_____
G. Security deposits
_____
_____
L. Accounts payable
_____
_____
M. Credit balances-accounts receivable
_____
_____
N. Discounts
TRUST, INVESTMENTS AND ESCROW ACCOUNTS (Dormancy 3 yrs.)
_____
_____
O. Refunds
_____
_____
P. Unredeemed gift certificates (Dormancy 5 yrs.)
_____
_____
A. Paying agent accounts
_____
_____
Q. Vendor checks
_____
_____
B. Trust Funds
_____
_____
R. Mineral proceeds
_____
_____
C. Funds held in fiduciary capacity
_____
_____
S. Royalties
_____
_____
D. Funds paid toward the purchase of shares, or, interest in
_____
_____
T. Rents
financial or business organization
_____
_____
U. Any other miscellaneous outstanding checks
_____
_____
E. Funds received for redemption of stocks and bonds
_____
_____
V. Any checks that have been written off
_____
_____
F. Stocks
_____
_____
W. Any other miscellaneous intangible personal property
_____
_____
G. Bonds
_____
_____
H. Any other certificates of ownership
COURT DEPOSITS (Dormancy 2 yrs.)
A.
Escrow funds
Any sum owing to a shareholder, certificate holder, member,
_____
_____
B.
Condemnation awards
bond holder or other security holder, or participating member
_____ _____
C.
Missing heir funds
of a cooperative such as:
_____ _____
_____
_____
I.
_____
_____
1. Dividends
_____
_____
D. Any other type of deposit made with a court or public authority
_____
_____
2. Interest
_____
_____
3. Principle payment
INSURANCE (Dormancy 3 yrs.)
_____
_____
4. Equity payments
_____
_____
5. Profits
_____
_____
A. Amounts due and payable under terms of insurance policies
_____
_____
6. Distribution
_____
_____
B. Claim payments
_____
_____
J. Escrow funds
_____
_____
C. Drafts
_____
_____
D. Matured whole life, term or endowment insurance policies or
OFFICIAL CHECKS (Dormancy 3 yrs. Unless otherwise noted)
annuity or supplemental contracts.
_____
_____
A. Certified checks
UTILITIES (Dormancy 3 yrs.)
_____
_____
B. Cashiers checks
_____
_____
C. Registered checks
_____
_____
A. Utility deposits
_____
_____
D. Bills of exchange
_____
_____
B. Membership fees
_____
_____
E. Drafts
_____
_____
C. Refunds
_____
_____
F. Warrants
_____
_____
G. Money Orders (Dormancy 7 years)
DISSOLUTION (Dormancy 60 days)
_____
_____
H. Travelers checks (Dormancy 15 years)
_____
_____
I. Any other official checks
_____
_____
A. Any intangible personal property distributable in the course of
_____
_____
voluntary dissolution, which is unclaimed within 60 days after
MISCELLANEOUS CHECKS AND INTANGIBLE PERSONAL PROPERTY
_____
_____
the date for final distribution, is presumed abandoned.
HELD IN THE ORDINARY COURSE OF BUSINESS (Dormancy 3 yrs.)
PROPERTY (Dormancy 3 yrs.)
_____
_____
A. Wages (Dormancy 1 yr.)
_____
_____
B. Commissions (Dormancy 1 yr.)
_____
_____
A. Contents of safe deposit boxes
_____
_____
C. Expense checks
_____
_____
B. Contents of any other safekeeping repository
_____
_____
D. Workman's Compensation
_____
_____
E. Pension checks
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