Form 04-720.b - Report Of Unclaimed Property As 34.45 - State Of Alaska - 2011
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1Name of Business (Holder)
Department of Revenue
STATE OF ALASKA
Treasury Division
REPORT OF UNCLAIMED PROPERTY
Unclaimed Property Section
AS 34.45
PO Box 110405
Federal EIN
Period Covered
Juneau, AK 99811-0405
Report and remit before November 1
A
B
C
D
E
F
G
H
I(a)
I(b)
J(a)
J(b)
K
Owner Last Name, First &
Each Owner's
Amount Due
Middle Initial (include prefix,
Identifying
Interest
Last Activity
Amount
Number of
Property Code
Property Type
SSN or Federal
Before
Ded. Code
CUSIP
Amount
suffix or title) Street Address,
Number
Bearing Y/N
Date
Deducted
Shares
EIN
Deductions
City, State, Zip Code
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
This form may be saved or reproduced as an Excel spreadsheet. When reporting more than 10 items please use NAUPA electronic format provided
Free at
Please include all property detail when reporting electroncially.
Although, items under $100 may be aggregated it is best to provide each property's detail.
Total
Please provide as much information as possible e.g. if no address is on file but a date of birth is available please provide the date of birth.
Page_____of______
(Please See Instructions for completing 04720)
Form 04-720.B (Rev Oct 2011)
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