N ( ) - Los Angeles County Assessor
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3BOE-577 (P1) REV. 06 (5-16) M-30 (REV. 8-16)
AIRCRAFT PROPERTY STATEMENT
577
2017
COUNTY OF LOS ANGELES • JEFFREY PRANG, ASSESSOR • Email: marineair@assessor.lacounty.gov • Website: assessor.lacounty.gov
(Declaration of costs and other related property information as of 12:01 A.M., January 1, 2017)
For information regarding antique aircraft exemption
, please contact our Major Exemptions Section at 213.974.3481
S
FILE RETURN BY
ASSESSOR, LOS ANGELES COUNTY, MARINE AND AIRCRAFT SECTION
500 W. TEMPLE ST., RM. 250, LOS ANGELES, CA 90012-2770
APRIL 3, 2017
u
TELEPHONE: 213.974.3119 Si desea ayuda en Español al número 213.974.3211
ASSESSOR’S USE ONLY
ASSESSOR’S USE ONLY
Assessor’s Office records indicate that you currently own, claim, possess or control the aircraft indicated below.
File No.
AIRPORT CODE
AIRPORT LOCATION
AIRCRAFT DESCRIPTION
PRIOR YEAR MARKET VALUE
ASSESSMENT NUMBER
PLEASE NOTE: This form must be filed timely with the Assessor’s office, regardless of the status
TAX RATE
ASSESSOR’S IDENTIFICATION NUMBER
AREA
MAP BOOK
PAGE
PARCEL
of any Historical Aircraft Exemption Claim. Penalties will apply if not filed.
NAME AND MAILING ADDRESS (Make necessary corrections to the printed name and mailing address.)
TOTAL M.V.
SECTION I: MUST BE COMPLETED ANNUALLY
FAA REGISTRATION NUMBER
DAYTIME PHONE NUMBER
AIRCRAFT LOCATION (AIRPORT, HANGAR OR TIE-DOWN NUMBER)
ASSESSOR’S
(
)
N
USE ONLY
MANUFACTURER
MODEL
YEAR BUILT
EXMPT CD
SERIAL NUMBER
PURCHASE DATE
PURCHASE PRICE
DATE MOVED TO THIS COUNTY
RETAIN
$
FOR AIRCRAFT PREVIOUSLY REGISTERED OR ASSESSED IN ANOTHER CALIFORNIA COUNTY, INDICATE COUNTY NAME AND ASSESSMENT YEARS
OVERRIDE
FIXED BASE OPERATOR NAME
LAST MAJOR AIRFRAME OVERHAUL DATE:
COST:
$
INACTIVE
AIRCRAFT CONDITION:
WHEN PURCHASED
NEW
DAMAGE HISTORY
GOOD
AVERAGE
POOR
DELETE
CURRENT
IF YES, SEE INSTRUCTIONS AND ATTACH STATEMENT.
NEW
GOOD
AVERAGE
POOR
YES
NO
EQUIPMENT LEASED, EXCHANGED, ADDED OR RETIRED
INTERIOR
NEW
GOOD
AVERAGE
POOR
A/C ______
YES
NO
IF YES, SEE INSTRUCTIONS AND ATTACH SCHEDULE.
LEGEND
EXTERIOR
NEW
GOOD
AVERAGE
POOR
TYPE OF USAGE:
PERSONAL/PLEASURE
BUSINESS
SHOW/MUSEUM
FLIGHT TRAINING
RENTAL
CHARTER/TAXI
FRACTIONAL OWNERSHIP PROGRAM
BILL#
IF YOU CHECKED CHARTER/TAXI, DO YOU USE THE AIRCRAFT IN COMMON CARRIAGE MORE THAN 50% OF THE TIME?
YES
NO
NOTE: COMMON CARRIAGE DOES NOT INCLUDE FERRY FLIGHTS OR PART 91 OWNER FLIGHTS.
AVIONICS SUMMARY: REPORT ONLY ADDED OR REPLACED AVIONICS. DO NOT REPORT ORIGINAL STANDARD FACTORY AVIONICS.
FOR CONDITION, PLEASE ENTER (N) NEW, (A) AVERAGE, (P) POOR.
ESCAPE
ASSESSOR
ACQUISITION
COST
ASSESSOR
ACQUISITION
COST
UNIT
CONDITION
CONDITION
UNIT
USE ONLY
DATE
NEW
USE ONLY
DATE
NEW
TYPE ____
RVSM
REDUCED VERTICAL SEPARATION
RADAR ALTIMETER
MINIMUM MONITOR
ESCAPE
TAWS
TERRAIN AWARENESS WARNING
ENCODER
SYSTEM
EA CODE
EFIS
RMI
ELECTRONIC FLIGHT INSTRUMENT
RADAR MAGNETIC
SYSTEM
INDICATOR
TCAS
VLF
ADD INTEREST
TRAFFIC ALERT COLLISION
AFTER____
VERY LOW FREQUENCY
AVOIDANCE SYSTEM
NAVCOM #1
PHONE
APPLY
10% PEN
NAVCOM #2
RADAR
AE
TRANSPONDER
LORAN
A_____ C_____
DEPUTY
ADF
GLIDESLOPE
AUTOMATIC DIRECTION
FINDER
DME
DATE
LOCALIZER
DISTANCE MEASURING
EQUIPMENT
COMPASS SYSTEM/HSI
APPROVAL
AIR CONDITIONING
HORIZONTAL SITUATION
INDICATOR
AUTOPILOT
DATE
BOOTS
NUMBER OF AXES ________
USE
YR
HF TRANSCEIVERS
CODE
AE
FLIGHT DIRECTOR
HIGH FREQUENCY
GPS IFR
OTHER NON-FACTORY
GLOBAL POSITIONING SYSTEM
AVIONICS
INSTRUMENT FLIGHT RULES
THE DECLARATION BY ASSESSEE ON PAGE 2 MUST BE COMPLETED AND SIGNED
THIS DOCUMENT IS NOT SUBJECT TO PUBLIC INSPECTION
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