Asd 159 Form PDF Details

The ASD-159 form is a crucial document for entities handling unclaimed property, outlining the procedure to report such assets accurately. Aimed at a wide range of holders including individuals, corporations, business associations, financial institutions, and government bodies, this form ensures compliance with the North Carolina Escheat and Unclaimed Property Law under North Carolina General Statute 116B. It acts as a companion to the Annual Report of Unclaimed Property (ASD-21) and Abandoned Tangible Personal Property (ASD-127), providing a structured format to convey necessary details such as holder's information, incorporation data, and contact details. Additionally, the form guides holders through the complexities of reporting, incorporating a segment on the late filing interest penalty which emphasizes the importance of timely submissions – outlining the financial consequences of delays past the November 1st deadline (or May 1st for life insurance holders). Moreover, the certification and verification section underscores the holder’s responsibility to ensure the accuracy and completeness of the report, asserting the due diligence performed in notifying property owners as mandated by the law. This form epitomizes the blend of regulatory compliance and the proactive stance taken by North Carolina in safeguarding the rights of property owners through methodical record-keeping and reporting.

QuestionAnswer
Form NameAsd 159 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesproperty unclaimed asd form, 159 form nc, asd 159 nc form, asd nc

Form Preview Example

FORM ASD-159

Unclaimed Property Verification

HOLDER NAME

 

 

 

HOLDER ID# (IF KNOWN)

 

 

 

 

 

 

MAILINGADDRESS

 

 

 

 

DATE OF INCORPORATION

 

 

 

 

 

CITY

STATE

ZIP CODE

NUMBER OF

STATE OF INCORPORATION

 

 

 

EMPLOYEES

 

 

 

 

 

 

CONTACT NAME

CONTACT E-MAIL ADDRESS

CONTACT PHONE

 

 

 

 

 

 

FEDERAL IDENTIFICATION NUMBER

-----

Every person, corporation, or other business association, banking or financial organization, insurance company, utility, court or public authority, etc. reporting unclaimed property must complete this form (ASD-159). It is to be filed with the Annual Report of Unclaimed Property (ASD-21), and/or Abandoned Tangible Personal Property (ASD-127). Refer to the Class Codes and Dormancy Period Chart for a listing of property types and associated dormancy periods covered by the North Carolina Escheat and Unclaimed Property Law, North Carolina General Statute 116B.

LATE FILING INTEREST PENALTY

In addition to any other penalties, any business, government or organization holder filing after November 1 (or life insurance holder filing after May 1) shall remit interest at the rate pursuant to North Carolina General Statute 116B- 77, currently 5%. Interest penalty is computed as follows: Total amount of property reportable X # of days late/365 X 5%=

Interest Penalty.

CERTIFICATION AND VERIFICATION

As the person authorized to bind this holder, I, being duly sworn, certify the attached report to be true and properly prepared and examined for correctness, ensuring that all property eligible to be remitted is included in this return, and the property reported has been held for the period required by North Carolina General Statute 116B-53. Further, I certify and verify that notices pursuant to North Carolina General Statute 116B-59 were sent to the owners at their last known address.

NAME-PRINT:

TITLE:

SIGNATURE:

REPORT CASH TOTAL:

INTERESTPENALTY:

TOTAL CASH REMITTANCE:

TOTAL SHARES OF SECURITIES:

DATE:

FORM OF CASH REMITTANCE:

FOR OFFICE USE ONLY

CHECK

WIRE

CD OR DISKETTE

REPORT IMPORT#

LOADED

KEYED

BALANCED

COMMITTED

RECEIPT ID

 

 

 

 

 

 

 

STOCK ID

CUSIP

SYMBOL

CERTIFICATE

DTC

DATE

CUSTODIAN

 

 

 

 

 

 

 

REV 10/2017

ASD-159

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