Unclaimed Property Holder Reporting Extension Request Form - Kentucky Department Of Treasury - 2008

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UNCLAIMED PROPERTY
HOLDER REPORTING EXTENSION REQUEST FORM
Due by November 1, 2008
KENTUCKY DEPARTMENT OF TREASURY
DIVISION OF UNCLAIMED PROPERTY
1050 US HWY. 127 S., SUITE 100
FRANKFORT KY 40601
Fiscal Year 2008 representing property presumed abandoned during the Fiscal Year ended June 30, 2008.
State the reason(s) an extension is requested: _______________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Check the additional time requested to complete the report:
30 days
60 days
We are aware of Kentucky’s requirement to remit by November 1, 2008, the total (or best estimate) of
abandoned property owed in order to avoid possible penalties. This extension only applies to the filing of the
Holder Report Form.
I am duly authorized to execute this request for an extension by the holder.
Holder Name ______________________________ Date of Request __________________________________
Contact Name _____________________________ Title ___________________________________________
Telephone No. _____________________________ Fax No. ________________________________________
Signature _________________________________________________________________________________
DEPARTMENT USE ONLY
The following criteria will be considered in evaluating the request.
Adequate
Inadequate
Previous Filing History (if filed)
_______
_______
Timeliness of Filing
_______
_______
Previous Extension Requests (consecutive)
_______
_______
___________________________________________________
Date __________________
Department Staff Member
Extension Approved ____
Extension Denied ____
Report will be due on _______________
MAIL THIS FORM TO THE ABOVE ADDRESS OR FAX TO (502) 564-4200
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