Form 04-720b - Report Of Unclaimed Property - 2013
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1Name of Business (Holder)
Department of Revenue
STATE OF ALASKA
Treasury Division
REPORT OF UNCLAIMED
Unclaimed Property
PROPERTY
PO Box 110405
Federal EIN
Period Covered
Juneau, AK 99811-0405
AS 34.45
(907) 465-3726
Report and remit before November 1
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
Owner Last Name
Property
Identifying
Interest
Owner
Owner SSN
Last Activity
Number of
Security
(include prefix, suffix, or
First Name
Middle Name
Address 1
Address 2
City
State
Zipcode
CUSIP
Amount
Code
Number
Y/N
Relationship
or FEIN
Date
Shares
Issue
title)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
Total Amount
This form may be saved or reproduced as an Excel spreadsheet. When reporting more than 10 items please use
NAUPA electronic format. Free at
Please include all property detail.
Please provide as much
Page_____of______
information as possible e.g. no address on file but a date of birth is available please provide the date of birth. This
will assist us in locating and identifying the owner.
(Please See Instructions for completing 04-720B)
Form 04-720B (Rev 2013)
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Parent category: Financial