Form Up-2c - Corporate Entity Owner Detail Report Form - 2013

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FORM UP-2C (REV 06/2013)
CORPORATE ENTITY
GEORGIA DEPARTMENT OF REVENUE
UNCLAIMED PROPERTY PROGRAM
OWNER DETAIL REPORT FORM
2013
BUSINESS NAME
PAGE _________ OF ___________
When reporting 25 or more properties, a NAUPA formatted CD
is required.
OWNER'S NAME, ADDRESS, CITY, STATE AND ZIP, LIST
PRO-
ALPHABETICALLY BY LAST NAME, FIRST AND MIDDLE
PERTY
IDENTIFYING
INITIAL. (IF JOINT OWNER, BENEFICIARY, TRUSTEE, ETC.
CODE
NUMBER
SPECIFY BY NAME.)
(3)
(1)
(2)
TOTAL (8)
$
IF THIS IS THE LAST PAGE, ENTER GRAND TOTAL
$

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