Fillable Nevada State Treasurer Unclaimed Property SafeKeeping Inventory (Nevada State Treasurer)

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Nevada State Treasurer Unclaimed Property SafeKeeping Inventory (Nevada State Treasurer)

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The Nevada State Treasurer Unclaimed Property SafeKeeping Inventory (Nevada State Treasurer) form is 5 pages long and contains:

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  • 1 check-box
  • 598 other fields

Country of origin: US
File type: PDF

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Nevada State Treasurer Unclaimed Property
SafeKeeping Inventory
{*Please do NOT include any paper clips, rubber bands or obvious trash on this report.}
Verified By:_________________ Date:_________________
Form UP-6
Holder Name____________
Holder TIN_____________
Contents of Forced Open Box or Other Repository
Br
anch/Location/Address:_______________________________________________________________________
Ow
ner Information:
Name(s):
SSN or TIN:
Last Known Address:
B
ox Information:
Box Number:
Date Rental Due:
Annual Rental Fee:
Drilling Fee:
Original Open Date:
This box contains (please check which apply):
___ Miscellaneous Paper Only (Stocks/Bonds/Wills are not considered Miscellaneous paper and must be detailed.)
___ Items detailed on the following pages.
___ Contains CASH (Must be listed in detail on inventory sheet AND on holder report.)
Holder Staff Signature:_________________
✔
click to sign
signature
click to edit
Owner Name:____________________ Box Number:______________________
2
Verified By:_________________ Date:_________________
Form UP-6
For State Treasurer’s Office Use Only
Please print extra pages if needed.
Does this box contain miscellaneous paper? YES / NO
MISCELLANEOUS ITEMS
QUANTITY
QUANTITY
ITEM DESCRIPTION
JEWLERY ITEMS
QUANTITY
QUANTITY
ITEM DESCRIPTION
Owner Name:____________________ Box Number:______________________
3
Verified By:_________________ Date:_________________
Form UP-6
US CURRENCY
US COIN
Qty
Face Value
Amount
Qty
Face Value
Amount
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
Currency Sub Total
$
$
$
$
Coin Sub Total
Grand Total Coin & Currency: $__________________
US CONFEDERATE OR COLLECTIBLE BILLS
Qty
Face Value
Amount
U.S. PROOF/MINT COIN SETS/COIN FOLDERS
# Sets
Type of Coin Set
Face Value $
# Sets
Type of Coin Set
Face Value $
Grand Total Coin: $__________________
Owner Name:____________________ Box Number:______________________
4
Verified By:_________________ Date:_________________
Form UP-6
FOREIGN MONEY
FOREIGN COINS QUANTITY:__________
FOREIGN BILLS
Country
Qty
Face Value / Description
Country
Qty
Face Value / Description
CASINO GAMING CHIP
Casino
Qty
Face Value
Total
Casino
Qty
Face Value
Total
Owner Name:____________________ Box Number:______________________
5
Verified By:_________________ Date:_________________
Form UP-6
U.S. SAVINGS BOND ITEMIZATION - list each bond and corresponding information.
Name (S) on Bond
Face
Value$
Serial #
Name (S) on Bond
Face
Value$
Serial #
STOCK CERTIFICATES
Safe Keeping
Code
QTY
STOCK CERTIFICATES COMPANY NAME
# SHRS
CERTIFICATE NUMBER
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Nevada State Treasurer Unclaimed Property SafeKeeping Inventory (Nevada State Treasurer)

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Completed 20 July 2020

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