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RPD-41201
Rev. 02/27/2024 New Mexico Taxation and Revenue Department
New Mexico Report of Unclaimed Property
Instructions
This form is used to summarize the report information from brief explanation.
RPD-41202, List of Owners of Unclaimed Property, RPD- 13. Successor and changed name
41203, List of Owners of Unclaimed Stock and Other Secu- If holder is a successor, list the name(s) and FEIN(s),
rities, and RPD-41204, List of Unclaimed Contents of Safe SSN(s), or ITIN(s) of all previous holders of the property.
Deposit Boxes/Other Safekeeping Repositories. If holder changed name during the time in which they held
the property, list the prior name(s), state of incorpora-
Whenever possible, the Unclaimed Property Office (UPO ) tion, date the corporation changed names and FEIN(s),
encourage all holders to report their unclaimed property to SSN(s), or ITIN(s).
the UPO electronically online at http://holdernm.unclaimed-
property.com/. Section 3
14. Stock sent to Mellon Security Trust
The Taxation and Revenue Department (Department) will Mark box to indicate that stocks indicated on RPD-41203
ONLY accept electronic data in the NAUPA (National Un- have been delivered to the Taxation and Revenue Depart-
claimed Property Administrators) format. Note: The UPO ments (Department) transfer agent.
no longer accepts electronic media such as USB Drive or 15. Total amount due from last page
compact disks. Computer listings cannot be accepted in lieu Enter the total amount due of all pages of RPD-41202,
of the approved reporting forms unless all required data fields RPD-41203, and RPD-41204 as applicable to this return.
are included on the printout. Property type codes must appear 16. Copy of Stock
on the printout. Mark box to indicate that shares have been delivered to
the Departments stock custodian.
Effective July 1, 2006, all reports containing more than 25 17. Penalty
properties are required to be submitted electronically. Enter the amount of penalty applicable.
• A holder who fails to report, pay or deliver property
FORM INSTRUCTIONS within the time prescribed by the Uniform Unclaimed
Property Act (1995), or fails to perform other duties
Section 1 imposed by that act, shall pay a penalty of one hun-
1. Filing Status dred dollars ($100) for each day the report, payment
Mark only one box to indicate filing status. If marking or delivery is withheld, or the duty is not performed,
"Annual Report 20" indicate the year this report if for. If up to a maximum of five thousand dollars ($5,000).
marking "Verification for Period Ended" indicate the month • A holder who willfully fails to report, pay or deliver
and year this report is for. property within the time prescribed by the Uniform
2. Name of Holder Unclaimed Property Act (1995), or willfully fails to
Enter the name of the holder. perform other duties imposed by that act, shall pay
3. FEIN, SSN, or ITIN a penalty of two hundred fifty dollars ($250) for each
Enter the FEIN, SSN, or ITIN of the holder. day the report, payment or delivery is withheld, or
4. Mailing Address - City, State, Zip Code the duty is not performed, up to a maximum of seven
Enter the complete mailing address of the holder. thousand five hundred dollars ($7,500), plus twenty-
5. Name of Contact Person five percent of the value of any property that should
Enter contact person's name. have been but was not reported.
6. Contact Phone Number • A holder who makes a fraudulent report shall pay a
Enter contact person's phone number. penalty of five hundred dollars ($500) for each day
7. Contact Email Address from the date a report under the Uniform Unclaimed
Enter contact person's email address. Property Act (1995) was due, up to a maximum of
8. Forms Attached twelve thousand five hundred dollars ($12,500), plus
Mark all forms that included with this report. twenty-five percent of the value of any property that
Section 2 should have been but was not reported.
9. Do any other departments, branches, or subsidiaries 18. CUSIP Number
file reports using this same FEIN, SSN, or ITIN? Enter holder's Committee on Uniform Securities Identifica-
Mark only one box to indicate yes or no to question. tion Procedures (CUSIP) number, which consists of nine
10. Primary Business Activity characters (including letters and numbers) that uniquely
Briefly describe the nature of the type(s) of business in identifies a company or issuer and the type of financial
which you are engaging. instrument. The CUSIP number is issued by the CUSIP
11. Did holder file a report of Unclaimed Property last year? Service Bureau, which is operated by the American Bank-
Mark only one box to indicate yes or no to question. ers Association.
12. If no on previous item, please explain
If you indicated no to the previous question provide a
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