Form Upd Ss-1 - Annual Report Of Unclaimed Property - California State Controller'S Office
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1
2For Additional Reporting and Remitting Instructions
ANNUAL REPORT OF UNCLAIMED PROPERTY
log on to:
SECURITIES SUMMARY OF REPORTED ISSUES
Required For Remit Reports Only
This form must be completed and attached to the Holder Remit Report when reporting securities. The information reported on this form must match the securities reported on your Remit Report and the securities
transferred to the SCO's broker. When e-mailing this form, include in the subject line the REPORT ID number.
Holders transferring securities electronically must E-MAIL this form on the SAME DAY as you transfer the securities, to the following e-mail addresses:
CALIFORNIA STATE CONTROLLER'S OFFICE
ucpdtcss1@sco.ca.gov
AND ITS
BROKER
WELLS FARGO ADVISORS
REPORT ID
HOLDER
CONTACT
REPORTING
REPORTED
NON-TRANSFERABLE
CERTIFICATE
NUMBER
HOLDER NAME
FEIN
REMITTER NAME
CONTACT NAME
PHONE
CONTACT E-MAIL
REPORT DUE
FOR YEAR
CUSIP NO.
REPORTED SECURITY NAME
DTC SHARES
SHARES
SHARES
UPD SS-1 (Rev 3/11)
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