Fillable UNCLAIMED PROPERTY HOLDER REQUEST FOR EXTENSION HOLDER INFORMATION (State of Wyoming)

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UNCLAIMED PROPERTY HOLDER REQUEST FOR EXTENSION HOLDER INFORMATION (State of Wyoming)

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File type: PDF

U.S.A. forms for State of Wyoming

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WYOMING UNCLAIMED PROPERTY
307.777.5590
UPREPORTS@WYO.GOV
122 WEST 25TH ST., SUITE E300
CHEYENNE, WY 82002
HOLDER REQUEST FOR EXTENSION
Name:
Title: Email:
Signature:
Date of Request:
HOLDER INFORMATION
Holder Information:
Mailing Address:
Mailing Address:
Contact Person: Phone Number:
Tax/FEIN Number:
City:
State: Zip:
CERTIFICATION
REQUEST INFORMATION
I am requesting an extension for reporting year . I am aware of Wyoming’s requirement
to remit abandoned property annually by November 1. I am duly authorized to execute this request
for an extension.
Select additional time required to complete report:
Reason for Request:
30 Days
Reorganization/Merger
System Problems
Personnel Changes
New Computer Program
60 Days 90 Days Other
Other (Please explain):
This request must be submitted prior to the required filing due date. All reports are due November 1.
UNCLAIMED PROPERTY
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UNCLAIMED PROPERTY HOLDER REQUEST FOR EXTENSION HOLDER INFORMATION (State of Wyoming)

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Completed 27 January 2021

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