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It is important for Kavilco to have your most current shareholder contact information and to know who will receive your Kavilco shares after your death. The following are frequently requested affidavits and forms. Please contact us for other forms.

Shareholder toll free number:
800.786.9574

Fax completed forms:
206.624.8953

Mail completed forms:
Kavilco Incorporated
600 University Street, Suite 3010
Seattle, WA 98101-1129

E-mail:
Corporate Secretary

You must have Adobe Acrobat 6.0 version or better to view and print our forms. If you do not have this software installed on your computer, click here to download a free copy.

Address Change: Only a shareholder or their custodian can change his/her address. Kavilco cannot accept address changes by relatives or friends of the shareholder. For the protection of the shareholder, we encourage address changes in writing, which must include a valid signature. To change your address, Kavilco must have your name as it appears on Kavilco’s shareholder records and your Social Security number. Address Change form

Custodian ˜ Appointment of: If the recipient of a gift of Kavilco stock is less than 18 years of age, his or her parent or legal guardian may be appointed as a custodian of the shares. The shareholder who is gifting the stock may also elect to act as custodian. This form must be completed by the custodian to accept appointment. Custodian ˜ Appointment of form

Custodian ˜ Resignation of: Kavilco cannot arbitrarily change a minor’s custodian of record. Kavilco must have either a divorce decree awarding custody or a resignation from the custodian.

If a custodian voluntarily resigns, he/she must sign a Resignation of Custodian form in the presence of a Notary Public and return the form to Kavilco. If a new custodian is appointed, the new custodian must sign the Appointment of Custodian affidavit. Once the proper documents to change a custodian have been received, a new stock certificate will be prepared and the duplicate sent to the new custodian.

If shares are being transferred by court order (dissolution of marriage, divorce decree) and the court order does not identify the custodian of the stock, the transferer of the stock will be named as the custodian until the minor reaches the age of 18. Custodian ˜ Resignation of form

Direct Deposit: We encourage our shareholders to sign up for Direct Deposit to receive dividends faster and safer. There is no cost to sign up for Direct Deposit. Direct Deposit ˜ Enroll form

Divorce: If shares are being transferred by court order (dissolution of marriage, divorce decree) the shareholder must properly complete an Affidavit for Transfer of Kavilco Stock Relative to Divorce. The affidavit must also include a certified copy of the divorce decree, old stock certificate(s), Custodian Agreement Minor (if applicable), and Native status affidavit(s). If the court order does not identify the custodian of the stock, the transferor of the stock will be named as the custodian until the minor reaches the age of 18. Divorce form

Estate Settlement: In order to transfer the shares of a deceased shareholder to another, Kavilco must have the following:

1. Certified copy of the death certificate.
2. Affidavit for Transfer of Kavilco Stock According to Will; OR
3. Affidavit for Transfer of Stock with Executed Stock Clause (back of stock certificate); OR
4. Properly completed Testamentary Disposition form.
5. If there is no will or completed testamentary disposition form, then Kavilco requires a properly completed Affidavit for Transfer of Stock (Intestate Succession). For Alaska residents, the shares will be transferred according to the Alaska Statutes on Intestate Succession. However, if the decedent resided outside of Alaska, you will need to consult an attorney to determine Intestate Succession laws for that state or country.
6. Once Kavilco receives all the necessary documentation, stock certificates will be prepared, and any funds accrued to the decedent’s previous stock certificate will be divided among the heirs accordingly.

Estate ˜ Court Order form
Estate ˜ Intestate Succession form
Estate ˜ Testamentary form
Estate ˜ Will form

Gifting Your Shares: You can continue the Native tradition of giving by gifting your Kavilco stock to family members. ANCSA permits shareholders to gift any number of shares to a child, grandchild, niece, nephew, brother or sister. You may request a Gifting Packet from our Corporate Office, or download the forms here. Gifting Packet forms

Majority Status: Complete this form when a shareholder reaches the age of 18. When Kavilco receives the properly completed affidavit and documents, a new stock certificate will be prepared. Majority Status form

Name Change: If a shareholder’s name has changed due to marriage, divorce, adoption, etc., he/she must complete an Affidavit of Name Change, which must be signed in the presence of a Notary Public and returned to Kavilco.

The affidavit must include a copy of the marriage certificate, adoption or divorce decree stating that the shareholder’s name has been legally changed.

When Kavilco receives the properly completed Name Change affidavit and documents, a new stock certificate will be prepared. Name Change form

Native Status: A person who receives a gift of shares must be either an Alaska Native or a descendent of a Native, including adopted descendents. However, a recipient need not have a particular blood quantum to be eligible to receive shares. Native Status form

Voluntary IRS Tax Withholding: A shareholder can request that Kavilco withhold a percentage of your dividends to pay the IRS. Complete this form, specifying what percentage of your dividends you wish to withhold and mail the form to Kavilco. You may revoke this form in writing at any time. Voluntary IRS Tax Withholding form

Please send an e-mail request or call our toll free shareholder number 800.786.9574 for more information regarding shareholder records. We welcome your comments and feedback.

 

AFFIDAVITS & FORMS
Address Change
Custodian ˜ Appointment of
Custodian ˜ Resignation of
Direct Deposit ˜ Cancel
Direct Deposit ˜ Enroll
Divorce
Estate ˜ Court Order
Estate ˜ Intestate Succession
Estate ˜ Testamentary
Estate ˜ Will
Gifting Your Shares
Lost Stock Certificate
Majority Status
Name Change
Native Status
Testamentary Disposition
Transferring Stock to a Minor
Voluntary IRS Withholding
IRS Form W-9

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