Form Up-1 - Unclaimed Property Report, Form Up-2 - Unclaimed Property Report Page 2
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2Page_____ of _______
FORM UP-2
HOLDER INFORMATION:
To: State Treasurer of Mississippi
Name of Business
Unclaimed Property Division
_____________________________________
P. O. Box 138
STATE OF MISSISSIPPI
Street Address
Jackson, MS
39205-0138
_____________________________________
UNCLAIMED PROPERTY REPORT
City, State, Zip Code
_____________________________________
Contact
Phone
REPORT YEAR __________
PERIOD COVERED _______________ TO _______________
_____________________________________
OWNER’S LAST NAME, FIRST NAME
PROPERTY
OWNER SOCIAL
DATE OF LAST TRANSACTION
AMOUNT REPORTED
STREET ADDRESS
DESCRIPTION &
SECURITY NUMBER
OR DATE PROPERTY BECAME
AS DUE OWNER
CITY, STATE, ZIP CODE
IDENTIFYING NUMBER
PAYABLE / RETURNABLE
COUNTY (IF KNOWN)
LIST ALPHABETICALLY BY LAST NAME
FILE THIS COPY ON OR BEFORE NOVEMBER 1 WITH FORM UP-1
TOTAL
NOTE: ITEMS LESS THAN $100.00 MAY BE REPORTED IN AGGREGATE
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Parent category: Financial