Free Louisiana Up 1 Form
The Louisiana Up 1 form is a crucial document for businesses and entities holding unclaimed property in the state. This form serves as the official report of unclaimed property verification and must be submitted annually by November 1. It includes essential details such as the holder's name, contact information, and federal ID number, along with specifics about the unclaimed property being reported. The form requires information about the report year and the period covered, ensuring that all necessary data is captured accurately. Additionally, holders must indicate whether they filed a report in the previous year and provide explanations if they did not. The Up 1 form also includes a section for remittance, where holders must calculate and submit the total amount due, including any interest or penalties. To validate the report, an official verification statement is included, requiring a signature, title, and date from the reporting individual. This thorough process not only helps maintain compliance with Louisiana's unclaimed property laws but also protects the interests of individuals who may be entitled to unclaimed assets.
Sample - Louisiana Up 1 Form
Rev. 02/2013 |
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State of Louisiana |
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Department of the Treasury |
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Unclaimed Property Division |
This form may |
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P.O. Box 91010 |
be reproduced |
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Baton Rouge, LA |
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(225) |
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LOUISIANA REPORT OF UNCLAIMED PROPERTY VERIFICATION |
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Report Year: __________________________________ Period Covered: _________________ to ________________
FILE BEFORE NOVEMBER 1.
If the due date falls on a weekend or holiday, the report is due on the next business day and becomes delinquent on the first day thereafter.
Holder Account Number |
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(If Known) |
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Holder Name: |
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Address 1: |
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Address 2: |
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City, State, Zip: |
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Contact Person: |
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Telephone Number: |
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Fax Number: |
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Email Address: |
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Federal ID Number: |
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State of Incorporation: |
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Date of Incorporation: |
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Primary Business Activity: |
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Did you file a report of |
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Unclaimed Property last year? |
YES |
NO |
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If NO, please explain: |
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If you are the successor to a previous holder of the property, or if you have changed your name or address, please make corrections and list your previous name below:
Previous Name:
Previous Address:
Previous City, State, Zip:
YOUR REMITTANCE MUST ACCOMPANY THIS REPORT
PLEASE MARK ONE: |
Annual Report (DUE NOVEMBER 1) |
Supplemental/Additional Report |
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Total Amount Due From Last Page: |
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$ |
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Interest: |
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$ |
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Penalty: |
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$ |
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Total Remittance: |
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$ |
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Total Number of Shares of Stock: |
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OFFICIAL VERIFICATION OF REPORT
I, __________________________________, hereby declare, under penalty of perjury, that to the best of my knowledge
and belief, the following documentation contain a full, true, and complete report consisting of ____ page(s) totaling
$____________ regarding to the property presumed abandoned, remitted with this documentation, under the
provisions of La. R.S.
I further declare that this documentation contains complete and accurate information pertaining to the
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Signature of Official |
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Date |
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Form Characteristics
| Fact Name | Details |
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| Form Purpose | The Louisiana UP 1 form is used to report unclaimed property to the Louisiana Department of the Treasury. |
| Filing Deadline | Reports must be filed by November 1 each year. If this date falls on a weekend or holiday, the report is due the next business day. |
| Governing Law | The form is governed by Louisiana Revised Statutes, specifically La. R.S. 9:151-181. |
| Remittance Requirement | A remittance must accompany the report, including amounts due, interest, and any penalties. |
| Verification Statement | The form requires an official verification statement, signed under penalty of perjury, confirming the accuracy of the report. |
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