Instructions For Form Up-1 - Unclaimed Property Report - Holder Information
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1Unclaimed Property Report - Holder Information
INSTRUCTIONS
Unclaimed Personal Property:
An Unclaimed Personal Property Report must be filed, by general business and financial
institutions, before November 1, for unclaimed property appearing on the holder’s records
as of the preceding June 30.
Unclaimed Life Insurance:
An Unclaimed Life Insurance Report must be filed, by life insurance companies, before
May 1, for unclaimed funds held under a life or endowment policy, and any unclaimed
personal property appearing on the holder’s records as of the preceding December 31.
Property Under $25.00:
May be reported in the aggregate. Full payment and confirmation of securities must
accompany the report. Include all applicable interest/income/dividends accrued to the date
of the report. Negative reports are required.
HOLDER’S FEDERAL EMPLOYER TAX ID NO: Enter the federal taxpayer identification number of the holder.
HOLDER NAME: The full entity name must be entered.
HOLDER ADDRESS: Enter the holder’s current address where future forms should be mailed. The address of the organization
or institution preparing the report if other than the holder should not be entered.
REPORT CONTACT INFORMATION: Identify the party to be contacted regarding the report content.
CLAIMS CONTACT INFORMATION: Identify the party to be contacted if information is needed to resolve a claim.
REPORT TOTALS: Enter the total cash remitted/reported and securities remitted/reported for magnetic media and/or report
form UP-2. The amount reported must equal the amount remitted. Enter the number of items reported on magnetic media and/or
report form UP-2. Enter the number of cartridges/tapes which represent the report, or the number of pages of UP-2 information.
ISSUE REMITTED: The name(s) of the security or mutual fund family being remitted with this report. This information must
be provided for every issue remitted to the State. If remitting more than one issue, attache a separate sheet for each issue.
TYPE: The classification of the remitted security or mutual fund.
Example: common, preferred 2.75.
CUSIP NO: The CUSIP number of the remitted security.
SPLIT: Identify all the splits included in the remittance of this report. The date(s) of occurrence must be completed.
SPIN-OFF: Identify all spin-offs included in the remittance of this report. The date(s) of occurrence must be completed.
CASH DIVIDEND(s): A cash distribution from a security. This amount must be reported as one sum, regardless of the number
of dividends. The from and to date section must be completed in a MMDDYY format.
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.
STOCK DIVIDEND(s): Percentage rate given for stock dividend. This item should be reported as shares, unless fractional
shares have been converted to cash and reported as cash-in-lieu (SC09). The date of occurrence must be completed.
UNDELIVERABLE TO THE STATE OR FOREIGN: All securities that cannot be re-registered in the nominee name of
“Neary Penco.” The date of occurrence must be completed. These securities should be segregated and remitted in a separate
report.
OTHER: Reverse split, recapitalization or other variants. The date of occurrence must be completed. The rate of exchange
should be completed as applicable.
IS THE ISSUE REMITTED, Y or N: Y = the owner holds the security being remitted. N = the owner holds a certificate
different from the security being remitted.
CERTIFICATION:
This must be signed and dated the appropriate officer of the holder.
Any funds that accrue
interest/income/dividends while in possession of the holder must continue to accrue interest/income/dividends to within 10 days
of the date of payment to the State Treasurer.
UP-1 Instructions
(4-95)
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