Unclaimed Nclaimed Property - Reporting Booklet - Washington Department Of Revenue Page 12
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28INSTRUCTIONS FOR COMPLETING
THE SECURITIES REPORT FORM REV 80 00024-1
The Report of Unclaimed Property for
E. COLUMN ENTRIES:
All shaded areas are for
Securities is used to report:
Department use only.
Ø
Ø
Column 1:
Enter the property category code.
common stock
stock warrants
Refer to the Property Type Code table on page
Ø
Ø
23.
preferred stock
partnership units
Column 2:
Enter the cusip number for the security
Ø
Ø
restricted stock
mutual funds
being reported.
Ø
bonds/debentures
Column 3:
Department use only.
Ø
dividend reinvestment plans
Column 4:
Enter the name of the corporation that
has securities being reported.
Ø
any other security type of property that has
Column 5:
List the last name, full first name and
been considered abandoned
full middle name. Please include information to aid
in identification of an individual, such as Jr., Sr.,
Any monetary type property, even if it is related to a
Miss, Mrs., etc., after the middle name (for
security (for example, dividends) should be reported
example, Smith, Jane Ann, Mrs.). If an owner’s
on the Detail Report of Unclaimed Property.
name is unknown for an item, please enter “UN-
KNOWN” as the name.
Abandoned property types are defined by the Uni-
form Unclaimed Property Act, RCW 63.29.
Corporate titles, etc., must be entered exactly as
adopted. The word “The” should be omitted when
Please type or legibly print your report.
it is the first word in a title. If there are two or
more owners, the names of all must be shown
A. HOLDER:
Enter the holder’s name and address
along with the relationship (for example, “and”,
exactly as it appears (after corrections, if any) on
“or”, “trustee for”, “trustee under the Uniform Gift
the Summary Report for Unclaimed Property.
to Minors Act (UGMA)”, etc.)
B. HOLDER NUMBER:
Enter the Washington
List the complete last known address even if you
State unclaimed property holder number assigned
have documentation that indicates that the last
to you, if known. Use this number on all related
known address is not valid. (This information is
correspondence.
vital in identifying the proper owner when claims
are processed.) If no address is available write
C. REPORT YEAR:
Enter the year for which the
“UKNOWN.”
report is being filed.
Column 6:
Enter the owner’s social security
D. PAGE:
Enter the page number of the report (for
number.
example, 1 of 2).
Unclaimed Property Reporting Booklet
11
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