Form Up-2a - Unclaimed Property Report - Owner Information

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Unclaimed Property Report - Owner Information
INSTRUCTIONS
(Omit All Punctuation)
** CASH AND SECURITIES CANNOT BE REPORTED ON THE SAME OWNER RECORD
A SEPARATE OWNER RECORD MUST BE ESTABLISHED FOR EACH TYPE OF PROPERTY.
The Holder must make the number of photocopies necessary to accommodate owner records being reported. Please review
the photocopies to ensure they are of readable quality. The original forms must be submitted to the State and the Holder should
retain a copy for their records.
HOLDER INFORMATION: Enter the full entity name as entered on the Holder Information UP-1 form. Indicate page reference and date of
report period in the appropriate areas.
OWNER NAME: Enter the last name, first name, middle initial of the owner of the property. Add suffixes as they appear on the records of the
holder (ex. Jr., Sr., III, etc.). Omit “The” when it is the first word of a corporate or entity name. An entity name may continue into the first name
field. If the name is unavailable, enter “Unknown.”
OWNER ID / SS#:: Enter the owner’s Social Security number or the Federal Taxpayer ID number if the owner is a corporation or entity.
NUMBER OF OWNERS: Use this block only if there are two or more owners. Enter the number of owners.
OWNERSHIP TITLE: Enter the full ownership title if there are two or more owners.
Example:
Joe Doe and Mary Doe JT or Margaret Dixon as Custodian for Jean Dixon UGMA NJ.
OWNER ADDRESS STREET 1, STREET 2, CITY: Enter the last known address. If unknown, leave blank.
STATE: Enter the two letter abbreviation, as used by postal authorities.
ZIP: Enter the 5 digit US Postal Service zip code. Include the 4 digit supplementary zip code if known.
COUNTRY: Enter only if it is not the United States.
PROPERTY TYPE CODE: Enter the appropriate code as shown on the Property Type Code Table.
PROPERTY ID NUMBER: Enter the number by which the holder identifies the property, for example: certificate number, insurance policy
number, account number, check number.
DATE (MMDDYY): For unclaimed checks, enter the check date. For unclaimed deposits, enter the date of the last contact with the owner. For
unclaimed life insurance funds, enter the payment date.
CASH REPORTED: Enter the cash or check amount being reported. Each property must be listed separately.
SECURITIES REPORTED: Enter the number of shares of stock or mutual funds reported for each owner. Each property must be listed
separately.
TRANSFER METHOD: Used for securities only. Enter the proper one digit code. T=Book Entry; P=Physical, certificates sent with report.
OWNER CUSIP NUMBER: Enter the CUSIP number on the security that belongs to the owner.
OWNER CERTIFICATE NUMBER: Enter the certificate number on the security that belongs to the owner.
CASH DIVIDEND(s): Each owner should only have one entry for all reportable cash dividends for each issue. Place the beginning date in the
first field and the last reportable dividend date in the second. The ending date should coincide with the date of the transfer of the security to the
State Treasurer if a security is being transferred. Example: Cash dividends from 7/1/89 through 6/30/90 presumed to be abandoned in 1995. If
underlying shares are being reported, all previously unreported cash dividends to the dated date of the transfer are to be included.
DATED DATE OF REMITTED SECURITY: The date when the security was placed in the nominee name of “Neary Penco”.
DESCRIPTION OF PROPERTY / ISSUE NAME: Identify the name of the issue relating to the owner’s CUSIP and certificate number and
the type of security being reported. If cash relating to securities is being reported, a description must be entered along with the conversion rate.
Enter any other information pertinent to the property being reported.
AGGREGATE (Items under $25.00) REPORTING INFORMATION: Items under $25.00 each, should be reported in the aggregate. (i.e.
Enter in the Property Code box “AC99” of the category “Account Balances Due” to identify an aggregate record of all properties of less than
$25.00). When reporting an aggregate a breakdown is not necessary. Enter “Aggregate” in the Owner Last Name box, the number of items
comprising the aggregate in the First Name box and the aggregate sum in the Cash Reported box. Report in the aggregate or the detail not both.
SECURITY DEFINITIONS
SHARES REPORTED: The amount reported will be the total due the owner as of the date of remittance. The certificates must be canceled on
the books of the issuer and reissued to “Neary Penco.” In addition to the issue name and number of underlying shares held by the owner, all cash
and stock dividends payable on the underlying shares as of the date of remittance must be reported and paid. Shares may be reported as SCO8,
SC10, SC12, SC22 or SC23.
UNDELIVERED SHARES (SC08): The number of shares remitted which were undelivered to the owner. If this security is a spin-off, the
name of the spin-off should be noted in the Description of Property / Issue Name box on the UP-2 form.
UNEXCHANGED SHARES (SC10): The number of shares of the successor corporation which are being remitted. In the Description of
Property / Issue Name box on the UP-2, describe the exchange of predecessor company shares for the successor company.
Examples:
XYZ Corp. merged into ABC Corp. One share of XYZ is exchangeable for 1/4 share of ABC.
An owner fails to exchange 100 shares of XYZ. The 25 shares of ABC (the successor) are noted in the Securities Reported
box on the UP-2 form. In the Description of Property/Issue Name box, note that the 100 shares of XYZ (unexchanged) are
outstanding and presumed to be in possession of the owner.
In the event of a claim the Unclaimed Property will request the 100 unexchanged shares of XYZ from the owner in order to
release the 25 shares of ABC.
If unexchanged successor company securities are being exchanged for cash, the cash amount should be entered into the cash
reported box on the UP-2. The number of shares of the predecessor company held by the owner and the issue name and rate
of exchange must be noted in the Description of Property / Issue Name box on the UP-2.
UNDERLYING SHARES (SC12): The number of underlying shares held by the owner.
UNDELIVERABLE, BOOK ENTRY (SC22): Securities that cannot be re-registered in the nominee name of “Neary Penco” or Foreign stock
items that are not presently being traded.
UNDELIVERABLE, PHYSICAL (SC23): Same as SC22 but refers to the Physical Certificates.
UP-2 Instructions (4-95)

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