The Arizona 652 form is a document used to report abandoned property to the Arizona Department of Revenue. This form helps holders, such as financial institutions or businesses, to disclose unclaimed assets that may belong to individuals. Properly completing this form ensures that rightful owners can reclaim their property and helps maintain transparency in the handling of abandoned assets.
The Arizona 652 form, officially known as the Report of Abandoned Property, is a crucial document for individuals and businesses in the state of Arizona. This form is used to report unclaimed property to the Arizona Department of Revenue's Unclaimed Property Section. It captures essential details such as the holder's name, federal employer identification number, and the total amount remitted. Each entry on the form requires specific information about the abandoned property, including account numbers, cash amounts, interest rates, and the last activity date. Additionally, it collects personal information about the owners, such as their names, mailing addresses, tax identification numbers, and dates of birth. If there are multiple owners for a property, the form provides space to include details for each additional owner. This ensures that all relevant parties are accounted for in the reporting process. Completing the Arizona 652 form accurately is vital for compliance with state laws and for the rightful owners to reclaim their property.
ARIZONA FORM Arizona Department of Revenue • Unclaimed Property Section
652 REPORT OF ABANDONED PROPERTY - SCHEDULE A
HOLDER NAME
Federal Employer Indenti
Grand Total Remitted
$
Item no.
Account #
Check #
NAUPA property type
Cash amount remitted
Interest rate
Last activity date
Owner’s last name
Owner’s first name / middle initial
Owner’s mailing address
City, State, ZIP code
Country
Owner’s Tax ID (SSN or EIN)
Owner’s date of birth
NAUPA relationship code
Fee/Drilling cost
No.of shares remitted
Security/Mutual Fund name
CUSIP no.
Date of Death
COMPLETE THE FIELDS BELOW IF THERE IS MORE THAN ONE OWNER FOR THIS PROPERTY
Additional owner’s last name
Additional owner’s first name / middle initial
Additional owner’s Tax ID (SSN or EIN)
Relationship code
Additional owner’s date of birth
Additional owner’s date of death
Other information available
Additional owner’s first name
/ middle initial
PAGE OF
ADOR 11017 (8/11)
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