Form Up 8-7 - Business Report Of Unclaimed Property - 2014
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West Virginia State Treasurer
Business Report of Unclaimed Property
FORM UP 8-7
ELECTRONICALLY REPORT ON OUR
E-HOLDER
SITE
Electronic Reporting is required for all Holder Reports with the exception of Law Enforcement agencies,
properties are to be submitted electronically via
E-Holder
or CD.
Complete this cover sheet and the attached forms and submit with your total remittance by November 1
(May 1 for Life Insurance).
FEIN/SSN:
ZIP CODE:
-
Business and Contact Information:
Holder Name:
__
Reporting Agent:
__________________ Report Year:
Sole Proprietor
Partnership
Limited Liability Company
Holder Mailing Address:
:
City:
State
-
-
:
Contact Person:
Phone
-
-
:
Email:
Fax
Check this box if you are a “government agency” or “government operated”.
Does this report include securities? If yes, use form UP 8-9.
Does this report include tangible items? If yes, use form UP 8-10.
Is this a negative report? (Not required to submit but may be submitted electronically via E-Holder)
Please complete the following:
I, ________________________________, hereby declare, under penalty of perjury, that to the best of my
knowledge and belief, the following sheets contain a full, true, and complete report consisting of
number of properties,
$
.
shares of stock and / or inventory sheets listing contents of
number of safe deposit boxes, safekeeping, or other tangible property as to property
presumed abandoned under the provisions of the Uniform Unclaimed Property Act. In accordance with
WV Code §36-8-7(e), written notice has been sent to the apparent owner of property over $50.00.
/
/
Signature:
Date:
Revised 4/1/2014
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