The Oklahoma Unclaimed Property 496 Up form serves as a verification and checklist for holders of unclaimed property in Oklahoma. This form, issued by the Oklahoma State Treasurer's Unclaimed Property Division, requires detailed information about the reporting company and the unclaimed assets held. Accurate completion of this form is essential for compliance with state law and to facilitate the proper handling of unclaimed property.
The Oklahoma Unclaimed Property 496 Up form serves as a crucial tool for businesses and organizations in reporting unclaimed property to the state. This form, administered by the Oklahoma State Treasurer's Unclaimed Property Division, requires detailed information regarding the holder company, including its name, state of incorporation, and any previous names or addresses. The form includes a comprehensive checklist that must be completed prior to filing, ensuring that all relevant property types are reported accurately. Various categories of unclaimed property, such as bank accounts, insurance benefits, and uncashed checks, are outlined, each accompanied by specific codes and abandonment periods. The form also emphasizes the importance of verifying the report's accuracy, requiring the holder to attest to its completeness under oath. By following the guidelines set forth in this form, organizations can fulfill their legal obligations while helping to reunite individuals with their lost or forgotten assets.
Form Number 496-UP -Revision 06/11/2013
OKLAHOMA STATE TREASURER UNCLAIMED PROPERTY DIVISION
REPORT OF UNCLAIMED PROPERT – VERIFICATION AND CHECKLIST
Verification for Period Ended _______________, ______
Provide the name of the holder company reporting for the period indicated. List the prior name(s), FEI(s), or address(es) if the company has had a change in these items during the time period in which it has held the property being reported.
Name ________________________________________________________
State of Incorporation______________________________________
_____________________________________________________________
Date of Incorporation _______________________________________
Address ______________________________________________________
Federal Employer ID#_______________________________________
Every person, corporation, or other business association, banking or financial organization, life insurance corporation, utility, court or public authority must complete the following checklist before filing their Oklahoma Unclaimed Property Report. This checklist includes by way of illustration, but not limitation, those items which are covered by Sections of the Oklahoma Unclaimed Property Law.
Please complete the checklist by indicating the items being reported. A “Yes” must be enumerated on Unclaimed Property Form 497-UP-2.
Property Type Codes and Abandonment Periods
Account Balances Due
Yes
No
Code Description
Yr
Code
Description
___
AC01
Checking Accounts
5
AC06
Security Deposits
AC02
Savings Accounts
AC07
Unidentified Deposits
AC03
Matured CD or Saving Certificate
AC08
Suspense Accounts
AC04
Christmas Club Funds
AC99
Aggregate Account Balances
AC05
Money on Deposit to Secure Fund
Court Deposits
CT01
Escrow Funds
1
CT04
CT02
Condemnation Awards
CT05
Other Court Deposits
CT03
Missing Heirs’ Funds
CT99
Aggregate Court Deposits
Health Savings Plan
HS01
Health Savings Account
HS02
Insurance
IN01 Individual Policy Benefits or Claim Payments
IN06
Unidentified Remittances
IN02 Group Policy Benefits or Claim Payment
IN07
Other Amounts Due Under Policy Terms
IN03 Proceeds Due Beneficiaries
IN08
Agent Credit Balances
IN04 Proceeds from Matured Policies,
IN09
Proceeds from Demutualization
2
Endowments, or Annuities
IN10
Shares of Stock from Demutualization
IN05 Premium Refunds
IN99
Aggregate Insurance Property
IRA’S (TRADITIONAL/ROTH)
IR01 Traditional IRA – Cash
7**
IR05
Roth IRA – Cash
IR02 Traditional IRA – Mutual Fund
IR06
Roth IRA– Mutual Funds
IR03 Traditional IRA – Securities
IR07
Roth IRA– Securities
** IRA’s are reportable 7 years after the participant has attained the age of 70 1/2.
Mineral Proceeds and Mineral Interests
MI01
Net Revenue Interest
MI06
Bonuses
MI02
Royalties
MI07
Delay Rentals
MI03
Overriding Royalties
MI08
Shut‐In Royalties
MI04
Production Payments
MI09
Minimum Royalties
MI05
Working Interest
Miscellaneous Checks and Intangible Personal Property
MS01
Wages, Payroll, and Salary
MS11
Refunds Due
MS02
Commissions
MS12
Unredeemed Gift Certificates
MS03
Worker’s Compensation Benefits
MS13
Unclaimed Loan Collateral
MS04
Payment for Goods and Services
MS14
Pension & Profit Sharing Plans
MS05
Customer Overpayments
MS15
Dissolution or Liquidation
MS06
MS16
Misc Outstanding Checks
MS07
Un‐refunded Overcharges
MS17
Misc Intangible
MS08
Accounts Payable
MS18
Suspense Liabilities
MS09
Credit Balance ‐ Accounts Receivable
MS99
Aggregate Misc Property
MS10
Discounts Due
Safe Deposit Boxes and Safekeeping
SD01
Safe Deposit Box Contents
SD03
Other Tangible Property
SD02
Other Safekeeping
Securities
SC01
Dividends
3
SC13
Funds for Liquidation/Redemption
SC02
Interest (Bond Coupons)
of Un‐surrendered Stocks or Bonds
SC03
Principal Payments
SC14
Debentures
SC04
Equity Payments
SC15
US Government Securities
SC05
Profits
SC16
Mutual Fund Shares
SC06
Funds Paid to Purchase Shares
SC17
Warrants (Rights)
SC07
Funds for Stocks and Bonds
SC18
Matured Bond Principal
SC08
Shares of Stock Returned by Post Office
SC19
Dividend Reinvestment Plans
SC09
Cash for Fractional Shares
SC20
Credit Balances
SC10
Un‐exchanged Stock of Successor Corp
SC21
Common Stock
SC11
Other Certificates of Ownership
SC22
Convertible Securities
SC12
Underlying Shares or Other
SC23
Preferred Securities
Outstanding Certificates
SC24
Fixed Income Securities
SC25
Real Estate‐Based Securities
Trust, Investment, and Escrow Accounts
TR01
Paying Agent Accounts
TR04
Escrow Accounts
TR02
Undelivered or Uncashed Dividends
TR05
Trust Vouchers
TR03
Funds Held in Fiduciary Capacity
7
TR99
Aggregate Trust Property
Uncashed Checks
CK01
Cashier’s Checks
CK10
Expense Checks
CK02
Certified Checks
CK11
Pension Checks
CK03
Registered Checks
CK12
Credit Checks or Memos
CK04
Treasurer’s Checks
CK13
Vendor Checks
CK05
Drafts
CK14
Checks Written Off to Income
CK06
Warrants
CK15
Other Outstanding Official Checks
CK07
Money Orders
CK16
CD Interest Checks
CK08
Traveler’s Checks
15
CK99
Aggregate Uncashed Checks
CK09
Foreign Exchange Checks
Utilities
UT01
Utility Deposits
UT04
Capital Credit Distribution
UT02
Membership Fees
UT99
Aggregate Utility Property
UT03
Refunds or Rebates
Please indicate the primary business activity of your company ________________________________________________________________________
Did you file a report of unclaimed property last year: YES ______ NO ______ If no, please explain: _______________________________________
Holder Contact: ___________________________________________________________________ Telephone Number: ________________________
Claim Person: ___________________________________________________________________ Telephone Number: ________________________
Address:__________________________________________________________________________________________________________________
State of ___________________________________________________:
County of _________________________________________________: SS
I, _________________________________________________________________, being first duly sworn, on oath depose and state that I have caused to be prepared
and have examined this report consisting of ________ pages totaling $ ____________, ______________ shares, and ____________ safekeeping items as to property
presumed abandoned under the Oklahoma Unclaimed Property Law for the year ending as stated, that I am duly authorized to execute this verification by the holder and by law and that I believe that said report is true, correct and complete as of said date, excepting for such property as has since ceased to be abandoned.
Signature ________________________________________________________________ Title _________________________________________________
Subscribed and sworn to before this _______________ day of ___________________________, _________________.
Notary Signature: _________________________________________________________________________________
My Commission Expires the __________________ day of _____________________________, _________________.
Mail reports and make checks payable to:
Oklahoma State Treasurer
Unclaimed Property Division
2300 N Lincoln Blvd., Rm. 217
Oklahoma City, Oklahoma 73105‐4895
Reporting: (405) 521‐4275
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