Form 04-720.b - Report Of Unclaimed Property - 2001
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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 remittance due on or before November 1
A
B
C
D
E
F
G
H
I(a)
I(b)
J(a)
J(b)
K
Interest
Amount Due
Owner Last Name, First & Middle Initial (include prefix,
Property
Identifying
Property
Each Owner's SSN or
Last Activity
Ded.
Amount
Number of
Bearing
Before
CUSIP
Amount
suffix or title) Street Address, City, State, Zip Code
Code
Number
Type
Federal EIN
Date
Code
Deducted
Shares
Y/N
Deductions
1
2
3
4
5
6
7
8
9
10
(This form may be reproduced on a spreadsheet)
Total
All items less than $100 may be reported in one
(If this is the last page of report, enter grand total)
aggregate amount - include number of items
(Please See Instructions)
Page_____of______
Form 04-720.B (Rev 01/01)
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