Form St-1 - Report Of Unclaimed Property
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1For Office Use
REPORT OF UNCLAIMED PROPERTY
_____________
_____
Holder:________________________________
Holder Id
Year
Suffix_____
UTAH STATE TREASURER
Attention: ______________________________
Receipt#__________________________________________
UNCLAIMED PROPERTY DIVISION
_________________________________________________
PO Box 140530
Mailing Address: ________________________
SALT LAKE CITY, UTAH 84114-0530
Securities and/or Safekeeping ________________________
______________________________________
_________________________________________________
Telephone: _____________Date: ___________
FILE BY NOVEMBER 1
Report balances as of close of business on June 30,___
Property
Amount Due Owner
Deductions (see
Date of Last
Owners Last Name, First Name
Identifying
Type
Before Deductions
Instructions)
Transactions
Street Address
Type of
Amount Reported as
Owners Social
Number
Code
And Withholdings
Amount
(See Instruction)
City, State, Zip
Deduction
Due Owner
Security Number
(1)
(2)
(3)
(7)
(8)
(5)
(4)
(6)
(9)
YOUR REMITTANCE MUST ACCOMPANY REPORT
REPORT OF UNCLAIMED PROPERTY FORM ST-1
TOTAL: ____________________
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Parent category: Legal