Address Line 2:
Holder Number:
Holder Name:
Federal I.D. Number:
Title:Contact Person:
Telephone Number:
05/2016
Compliance Division
Unclaimed Property Unit
410-767-1700 or 1-800-782-7383
New Holder Information Form
All fields are required
State:
Industry
Zip Code:City:
Address Line 2:
Location Address:
Zip Code:State:City:
Mailing Address:
Trade Name:
E-mail Address:
Print Form
Alabama
Alabama