Form Up-7 - Holder Request For Extension - State Of Idaho Office Of The State Treasurer
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1State of Idaho Office of the State Treasurer
Unclaimed Property
304 N. 8th St., Suite 208, Boise ID 83702-5834
HOLDER REQUEST FOR EXTENSION
HOLDER INFORMATION
Holder Information:
Tax/FEIN Number:
Mailing Address:
City:
State:
Zip Code:
Contact Person:
Phone Number:
Fax Number:
(
)
(
)
REQUEST INFORMATION
Select additional time required to complete report:
30 Days
60 Days
90 Days
Other
Reason for request:
Reorganization/Merger
Personnel Changes
New Transfer Agent
System Problems
New Computer Program
Other (please explain)
CERTIFICATION
I am requesting an extension for reporting year_________. I am aware of Idaho’s requirement to remit abandoned
property by November 1st and am duly authorized to execute this request for an extension.
Submit this form to the Idaho Unclaimed Property Office at least 30 days prior to the original filing due date. Your
report is due by November 1st, therefore this form must be completed and postmarked no later than October 1st.
Remittance is due when holder report is submitted.
Name______________________________________
Title_____________________________________
Phone No._______________________ Fax No.________________ Email_____________________________
Signature_______________________________________________
UNCLAIMED PROPERTY USE ONLY
The Idaho Unclaimed Property office will consider the following criteria in evaluating this request:
Satisfactory
Unsatisfactory
Previous Filing History (if filed)
Timeliness of Filing
Prior Requests for Extensions (consecutive)
___________________________________
Extension Approved
Extension Denied
Report Due on
Reason for denial
____________________________________________________________________________________________
_______________________________
________________________
______________________
Authorized Signature
Title
Date
UP-4 (Rev. 10/2012)
30
UP-7 (04/17/13)
30
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Parent category: Financial