Business Personal Property Rendition Form - Harris County Appraisal District
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BUSINESS
Harris County Appraisal District
*NEWPP130*
Business & Industrial Property Div.
PO Box 922007
PERSONAL PROPERTY RENDITION
Houston TX 77292-2007
*2017*
CONFIDENTIAL
January 1, 2017
For assistance, please refer to instructions on pages 3 & 4 of this form.
Form 22.15 (10/16)
Part 1. Property Owner Name, Business Name, Address, Phone and Physical Location or Situs [Required]:
Account Number
Business Name
Business Owner
iFile™ Number
Mailing Address, City, State, Zip Code
Agent Name
Property Location Address, City, State, Zip Code
Phone (area code and number)
Agent ID#
Part 2. Business Information: Please address all that apply. Optional but very important.
If business closed, were assets still in place as of Jan 1?
Yes
No
Sales Tax Permit Number
Business Start Date at Location
Business Closed Date
Ownership Type
Business Type
The business owned no
taxable assets in Harris
Individual
Manufacturing
Square Feet Occupied
Business Description
County as of Jan 1
Corporation
Wholesale
This is a new business or
New Owner
Business Sold Date
Partnership
Retail
location for the above tax
Other
Service
year
Business Moved Date
New Location, City, State, Zip Code
Part 3. Affirmation of Prior Year Rendition: (Check only if applicable and your assets were exactly the same as the prior rendition form).
By checking this box, I affirm that the information contained in the most recent rendition statement filed for a prior tax year (the
tax year) continues to be complete and accurate for the
current tax year. [If checked, you may skip to Part 6. "Signature and Affirmation"]
Part 4. Description of Assets: A description of assets is required unless you checked Part 3 of this form. Please check all that apply.
Inventory
Raw Materials
Furniture & Fixtures
Computers
Location (if different from above)___________________________________
Supplies
Work in Process
Machinery & Equipment
Miscellaneous
Describe Miscellaneous Assets: ____________________________________
Part 5. Market Value: What do you estimate to be the total market value of your business assets? [Required, unless you checked Part 3 of this form.]
Under $20,000
[If "Under $20,000" is checked, Page 2 is optional as long as a general description of the property by type or category has been provided in Part 4]
$20,000 or more
[if "$20,000 or more" is checked, you must complete all of Page 2.]
Part 6. Sign and Date Form:
This form must be signed and dated. By signing this document, you attest that the information contained on it is true and correct to the best of your knowledge and belief.
Notarization: Complete if signer is not a secured party, or owner, employee, or
Indicate if you are filling out
this form as:
officer of the company or affiliated company.
Signature
Printed Name
SUBSCRIBED AND SWORN TO BEFORE ME THIS:
Owner / Employee
day of
, 20
.
SEAL
Authorized Agent
Company Name
Title
Fiduciary
(
)
Secured Party
Phone No.
Date
Email (optional)
Notary Public Signature
State
If you make a false statement on this form, you could be found guilty of a Class A misdemeanor or a state jail felony under Section 37.10, Penal Code..
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