Form Rpd-41202 - List Of Owners Of Unclaimed Property
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1
2RPD-41202
State of New Mexico - Taxation & Revenue Department
Rev. 03/2011
LIST OF OWNERS OF UNCLAIMED PROPERTY
Page No._____ of ______
Holder (Name of Business)
Report Year
Federal ID Number
Address
Period Covered
State
City
ZIP Code
From: ________________________
To: ____________________________
(MM/DD/YY)
(MM/DD/YY)
Contact Name
Daytime Phone Number
E-mail Address
Social Security No.
Owner’s Acct. No.,
Date of Last
Amount
Owner Name
Rela-
Property
Last Known Address
Certificate No., or
(Principal +
or Federal Tax ID
Transaction
tion
Type
Last
First
Middle
Number & Street
Dividends
No.
Policy No.
Code
Code
City, State, ZIP
+ Interest)
(2)
(4)
(5)
(3)
(6)
(7)
(8)
(1)
TOTAL
of Col. #7
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Parent category: Financial