Under penalties of perjury, I declare that I have read the foregoing tax return and
that the facts stated in it are true. If prepared by someone other than the
taxpayer, the preparer signing this return certifies that his/her declaration is
based on all information of which he/she has any knowledge.
DATE: _____________ TITLE: ___________________________________________________
SIGNED: ______________________________________________________________________
(TAXPAYER ONLY SIGNATURE REQUIRED)
SIGNED: ______________________________________________________________________
(PREPARER)
ADDRESS: ____________________________________________________________________
PHONE NO: _____________________________ PREPARER’S ID: ___________________
1. Please Give Name and Telephone Number of Owner or Person in Charge. Name: ______________________________________________
Phone #: ______________________________________________ Fax #: ______________________________________________
2. Actual Physical Location of Corporately Owned or Rental Property (Street Address - NOT PO BOX): _____________________________
3. Is Your Rental/Corporate Owned Property Located Within the Incorporated Limits of a City? Yes _____ No _____
If Yes, what City? ____________________________________________
4. Do You File a Tangible Personal Property Tax Return Under Any Other Name? Yes _____ No _____
If Yes, Please Show Name Exactly as it Appeared on Your Most Recent Personal Property Tax Bill or Current Return
___________________________________________________________________________________________________________________________________
5. Date You Began Renting Property In This County: ________________________________
Seasonal __________ Annual __________ (Please check one)
6. Did You File a Tangible Personal Property Return in This County Last Year? Yes _____ No _____
If Yes, Under what Name and Address? _______________________________________________________________________________________
7. Please Indicate the Type of Property Y