Fillable UNCLAIMED PROPERTY EARLY REMITTANCE REQUEST HOLDER INFORMATION (State of Wyoming)

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UNCLAIMED PROPERTY EARLY REMITTANCE REQUEST HOLDER INFORMATION (State of Wyoming)

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CURTIS E. MEIER, JR
WYOMING STATE TREASURER
WYOMING UNCLAIMED PROPERTY
307.777.5590
UPREPORTS@WYO.GOV
2020 CAREY AVE. CHEYENNE, WY 82001
EARLY REMITTANCE REQUEST
Name:
Title: Email:
Signature:
Date of Request:
HOLDER INFORMATION
Holder Information:
Mailing Address:
Mailing Address:
Contact Person: Phone Number:
Tax/FEIN Number:
City:
State:
Received By:
Date Received:
Zip:
CERTIFICATION
OFFICIAL USE ONLY
REQUEST INFORMATION
What type of properties are you requesting to
be submitted early?:
What is the dormancy of the properties?:
Has due diligence been performed?:
Yes No
Reason for Request:
Request Accepted?
Yes No
I am requesting to file early. I am aware of Wyoming’s requirement to remit abandoned property
annually according to dormancy periods. I am duly authorized to execute this request for early
remittance.
WYOMING STATE TREASURER
UNCLAIMED PROPERTY
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UNCLAIMED PROPERTY EARLY REMITTANCE REQUEST HOLDER INFORMATION (State of Wyoming)

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Completed 27 January 2021

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