Form 497-Up-2 - Report Of Unclaimed Property - Oklahoma State Treasurer

Page ____1______

Of ____________

OKLAHOMA STATE TREASURER

HOLDER:

State of Oklahoma

Unclaimed Property Division

2300 N Lincoln Blvd., Rm 217

(City)

(State)

(Zip)

Oklahoma City, Oklahoma 73105-4895

FEDERAL EMPLOYER ID NO.:

REPORT YEAR :

REPORT OF UNCLAIMED PROPERTY

Note: According to OS Section 661B.1.  Report of Abandoned Property ‐  Items of value under Fifty Dollars ($50.00), should be reported in the aggregate, except property which is one of a recurring number of continuous

payments, including, but not limited to, royalties, annuities, dividends, etc. – see https://

PROPERTY

NAUPA

AMOUNT

ADDITIONS

AMOUNT PAID TO

AMOUNT

DATE OF LAST

OWNER'S LAST NAME, FIRST NAME, MIDDLE NAME

OWNER SOCIAL

DESCRIPTION PROPERTY

REPORTED

TO AMOUNT

OWNER OR DELETED

REMITTED

TRANSACTION OR

LAST KNOWN STREET ADDRESS

SECURITY NUMBER

ACCOUNT #

CODE

AS DUE

REPORTED

TYPE

AMOUNT

DATE PROPERTY

CITY, STATE, ZIP

OR FEI NUMBER

OR CHECK #

OWNER

BECAME PAYABLE

(See note below)

(1)

(2)

(3)

(4)

(5a)

(5b)

(6)

(7)

(8)

(9)

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

497-UP-2

(IF THIS IS LAST PAGE OF REPORT, ENTER GRAND TOTAL)

Revision 06/30/17

*Must be entered as a negative number in column 5b.