Annual Report Of Unclaimed Property - South Carolina Office Of State Treasurer printable pdf download

Annual Report Of Unclaimed Property - South Carolina Office Of State Treasurer

SOUTH CAROLINA OFFICE OF STATE TREASURER

ANNUAL REPORT OF UNCLAIMED PROPERTY

REPORT YEAR______________

HOLDER NAME

HOLDER ADDRESS

Check here if this is a new address

HOLDER FEIN

HOLDER CONTACT NAME

PHONE NUMBER E‐MAIL ADDRESS

Remittance amount $

The report is being filed (check one):

___ VIA E‐MAIL (You must also attach the Remittance Information Form with the e‐mailed report)

___ CD

___ DISKETTE

_________________________________________________________________________

I, _______________________________________________, CERTIFY THAT I HAVE CAUSED TO BE PREPARED AND

HAVE EXAMINED THIS REPORT AS TO PROPERTY PRESUMED ABANDONED UNDER THE SOUTH CAROLINA

UNCLAIMED PROPERTY LAW FOR REPORT YEAR _________, THAT I AM DULY AUTHORIZED TO EXECUTE THIS

VERIFICATION BY THE HOLDER AND BY LAW AND THAT I BELIEVE THAT SAID REPORT IS TRUE, CORRECT, AND

COMPLETE AS OF THIS DATE. THIS REPORT TOTALS # _______PROPERTIES FOR $______________________ AND

#_________________ SHARES.

Date___________Signature_______________________________Title_________________

Signed before_____________________________

On the_________of____________________20__

SEAL

My commission expires:____________________

Annual Report Of Unclaimed Property - South Carolina Office Of State Treasurer