Form Upc 4 - Report Of Unclaimed Property (Page 4 of 4) in pdf

In the case of stocks and bonds, use the STOCK

COLUMN 9: Enter the amount due the owner of the item.

CERTIFICATES FORM for reporting.

This is the amount of column 7 less the amount in column

8(b). This amount must be remitted to the State Treasurer.

File the original copy of this report along with the

Verification and Checklist before November 1 (May 1 for life

insurers).

COLUMN 8(a) and 8(b): Use column 7(a) to indicate

COLUMN 7 THROUGH 9: Total each column at bottom of

whether any deductions or withholdings were made using

each page. On the last page enter that page total and

these codes:

underneath the grand total for the report.

"S" for service charge deducted

Mail the completed report with your remittance (check or

"I" for interest withheld or discontinued

money order and any reported securities), and make a

"D" for dividends withheld or discontinued

photocopy for your files.

"N" for no deductions or withholdings

Funds previously remitted to the Division which the

Use column 8(b) to enter the amount of any service

holder later pays to the owner or discovers were

charges imposed by virtue of the inactivity or dormancy of

reported in error must be reclaimed.

the property. No service charges may be deducted from

any funds held by life insurance companies, property held

NOTE: Securities must be registered in the name: "State of

in the course of dissolution, property held by fiduciaries or

South Dakota, State Treasurer's Office, Unclaimed Property

property held by public agencies, authorities, corporations

Division".

or courts; and in no event may service charges be deducted

from an item after July 1 of the year in which it became

COMPUTER

REPORTS:

Computer

output

may

reportable.

accepted by the Division as a Report of Unclaimed

Property, if it follows the instructions and format of this form

This information must also be reported when the total of the

(prior approval mandatory).

service charges deducted from an item of property equals

or exceeds the value of the item.

ADDITIONAL INFORMATION AND FORMS: If you have

questions regarding your reporting obligations, please write

If service charges have been deducted, the holder shall

to the address given below.

include or attach as part of the report the citation of the

authority or a copy of the form of contracts authorizing such

Use of this form is required.

service charges.

If you need additional report forms, you may, if you wish,

If payment of interest or dividends on property presumed

photocopy the blank forms sent to you and complete your

abandoned was discontinued, before or after the property

report on those photocopies, or you may write to:

was presumed abandoned, by reason of the inactivity or

State Treasurer's Office

dormancy of the property, the holder shall include or attach

Unclaimed Property Division

as part of the report:

500 E. Capitol Ave.

Pierre, SD 57501-5070

a) A copy of the form of contract which authorized such

discontinuance of payment of interest or dividends; or

b) The citation of the authority for such discontinuance of

payment of interest or dividends.

A COMPLETED REPORT SHOULD BE SUBMITTED AND REMITTANCE MUST

ACCOMPANY THE REPORT.

Form Upc 4 - Report Of Unclaimed Property Page 4

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