State Treasurer of Iowa

Iowa State Treasurer's Office Unclaimed Property Holder Voluntary Self-Assessment Registration Form

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Previous Unclaimed Property Reporting to Iowa:
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DO NOT FILE A REPORT OF UNCLAIMED PROPERTY AT THIS TIME. Following the acceptance of the company’s self-assessment registration, the State Treasurer’s Office will prepare and issue a questionnaire to substantiate the sufficiency of the company’s unclaimed property accounting practices in conjunction with the voluntary reporting of past-due property.  Upon approval of the company’s unclaimed property accounting practices and the self-assessment work plan, the company will then be directed to report and deliver any past-due property.

FOR STATE TREASURER'S OFFICE USE ONLY:

Registration Accepted

By:____________________________________________________________

Title:___________________________________________________________

Date:___________________________________________________________

Tracking Number:_________________________________________________

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