Form Up-2 - Report Of Unclaimed Property printable pdf download

Form Up-2 - Report Of Unclaimed Property

Treasury Use Only

UP-2

OFFICE OF FINANCE AND TREASURY OFFICE OF

HOLDER___________________________________________________

UNCLAIMED PROPERTY - 1275 K STREET N.W.,

Receipt Number

WASHINGTON D.C. 20005

Receipt Date

Address___________________________________________________

City________________________State______Zipcode________

Amount

Report Year

_________________

Number

REPORT OF UNCLAIMED PROPERTY

Period Covered ________________

to ______________(Month/Day/Year)

DEDUCTIONS AND

DATE OF LAST TRANSACTION OR

OWNER'S LAST NAME, FIRST NAME, STREET ADDRESS,

AMOUNT DUE OWNERS

AMOUNT

DESCRIPTION OF PROPERTY OR

WITHHOLDINGS (See

DATE PROPERTY BECAME

OWNER SOCIAL SECURITY NUMBER

CITY, STATE, ZIP, COUNTY (IF KNOWN) (List Alphabetically

BEFORE DEDUCTIONS AND

AS DUE

PAYABLE, REDEEMABLE, OR

Instructions)

IDENTIFYING NUMBER

by Last Name)

WITHHOLDINGS

OWNER

RETURNABLE

TYPE

AMOUNT

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PAGE TOTAL

More than 25 items must be reported in NAUPA format on diskette

GRAND TOTAL

Form Up-2 - Report Of Unclaimed Property