Form Rpd-41202 - List Of Owners Of Unclaimed Property - 2014
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1
2RPD-41202
State of New Mexico - Taxation & Revenue Department
Rev. 2/4/2014
LIST OF OWNERS OF UNCLAIMED PROPERTY
Page No._____ of ______
Holder (Name of Business)
Federal ID Number
Report Year
Address
Period Covered
City
State
ZIP Code
From: ________________________
To: ____________________________
(MM/DD/YY)
(MM/DD/YY)
Contact Name
Daytime Phone Number
E-mail Address
Social Security No.
Owner’s Acct. No.,
Date of Last
Amount
Owner Name
Rela-
Property
Last Known Address
(Principal +
or Federal Tax ID
Certificate No., or
Transaction
tion
Type
Number & Street
Last
First
Middle
Dividends
No.
Policy No.
Code
Code
City, State, ZIP
+ Interest)
(2)
(3)
(4)
(5)
(6)
(8)
(7)
(1)
TOTAL
of Col. #7
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Parent category: Financial