Form Boe-571-L - Business Property Statement - 2016 Page 4

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BOE-571-D (P1) REV. 17 (05-15)
SUPPLEMENTAL SCHEDULE FOR REPORTING
MONTHLY ACQUISITIONS AND DISPOSALS OF
PROPERTY REPORTED ON SCHEDULE B OF THE
BUSINESS PROPERTY STATEMENT
OWNER NAME
MAILING ADDRESS
LOCATION OF PROPERTY
INSTRUCTIONS
Report all acquisitions and disposals reported in Columns 1, 2, 3, or 4 on Schedule B for the period January 1, 2015
through December 31, 2015. Indicate the applicable column number in the space provided.
ADDITIONS — Describe and enter the total acquisition cost(s), including excise, sales, and use taxes, freight-in, and installation charges,
by month of acquisition; transfers-in should also be included. The former property address and date of transfer should be reported, as well
as original date and cost(s) of acquisition.
Only completed projects should be reported here (e.g., the date the property becomes functional and/or operational, otherwise it should
be reported as construction-in-progress).
Identify completed construction that was reported as construction-in-progress on your 2015 property statement. Describe the
item(s) and cost(s), as previously reported, on a separate schedule and attach to BOE-571-D.
DISPOSALS — Information on this property should include the disposal date, method of disposal (transfer, scrapped, abandoned, sold,
etc.) and names and addresses of purchasers when items are either sold or transferred.
ADDITIONS
DISPOSALS
FROM
ENTER MONTH
FROM
ENTER MONTH
YEAR
COLUMN
& YEAR OF
DESCRIPTION
COST
COLUMN
& YEAR OF
DESCRIPTION
COST
ACQUIRED
NUMBER
ACQUISITION
NUMBER
DISPOSAL
THIS STATEMENT SUBJECT TO AUDIT

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