Ouf-5 List Of Owner Of Safe Deposit Box Contents And Safekeeping - Ohio Department Of Commerce - 2004
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1
2OHIO DIVISION OF UNCLAIMED FUNDS
Page No. _______ of _______
OUF-5 LIST OF OWNER OF SAFE DEPOSIT BOX CONTENTS AND SAFEKEEPING
HOLDER NAME
FEIN OR SSN
SAFE DEPOSIT BOX NO.
DATE OF LAST LEASE PMT
DATE FORCED OPEN
REPORTING YEAR
2004
DESCRIPTION
LASTNAME OR BUSINESS NAME
FIRST NAME
INTIAL
SSN OR FEIN
STREET ADDRESS:
RELATIONSHIP CODE
STREET ADDRESS:
CITY
STATE
ZIPCODE
DESCRIPTION
LASTNAME OR BUSINESS NAME
FIRST NAME
INTIAL
SSN OR FEIN
STREET ADDRESS:
RELATIONSHIP CODE
STREET ADDRESS:
CITY
STATE
ZIPCODE
NATURE OF
NUMBER OF
OFFICE USE
DESCRIPTION OF THE CONTENTS
FUNDS CODE
ITEMS
ONLY
Use the Back of this Form To List Additional Unclaimed Items
Group like items during the inventory process and provide the following for each item or group:
Nature of Funds Code: Enter the Nature of Funds Code corresponding to the description of funds. The Nature
of Funds Codes and descriptions are listed on page 28 of this booklet.
Number of Items: Enter the number of items for this item or group of items remitted. Coins should be
wrapped according to denomination or placed in appropriate containers.
Description of the Contents: Enter a description that best describes the unclaimed safe deposit box
contents remitted If reporting stock include the registered owner's name, issuing company and number
of shares
Joint Accounts or Accounts with Multiple Relationships: List the name and address information for each owner
separately in the two (2) owner information blocks provided. If the box has more that two (2) owners please attach
a separate sheet with their name and address information.
COM 5520 revised 5/2004
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