Form 571-R - Apartment House Property Statement - 2017
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3BOE-571-R (P1) (P2) REV. 18 (05-16) ASSR-524 (REV. 8-16)
APARTMENT HOUSE PROPERTY STATEMENT
201
571-R
7
COUNTY OF LOS ANGELES • JEFFREY PRANG, ASSESSOR, 500 W. TEMPLE ST., ROOM 230, LOS ANGELES, CA 90012-2770
Telephone: 213.974.8613 • Email: businesspp@assessor.lacounty.gov • Website: assessor.lacounty.gov • Si desea ayuda en Español, llame al número 213.974.3211
(Declaration of costs and other related property information as of 12:01 A.M., January 1, 2017)
ROUTING
SITUS
SUB
USE
ASSESSOR’S USE ONLY
FILE RETURN BY
TAX RATE
ASSESSOR’S IDENTIFICATION NUMBER
APRIL 3 , 2017 .
141
INDEX
INDEX
TYPE
CODE
ACCT FORM
AREA
MAP BOOK
PAGE
PARCEL
ASSESSOR’S USE ONLY
8
RETURN THIS ORIGINAL FORM. COPIES WILL NOT BE ACCEPTED.
0
1
COMPANY NUMBER
NAME AND MAILING ADDRESS
(Make necessary corrections to the printed name and mailing address.)
LOCATION OF THE PROPERTY
(street, city)
(file a separate statement for each location)
(21
3)
(21
3)
Local Telephone Number
Fax Number
2. Enter the total number of units for the location listed.
163
Email Address
Enter location of general ledger and all related accounting records (include zip code):
Do you live in one of the units?
Yes
No
CITY
STATE ZIP
Yes
No
STREET
If yes, enter the unit number ______________________________
Enter name and telephone number of authorized person to contact at location of accounting records:
3. During the period of January 1, 2016 through December 31, 2016:
(1) Did any individual or legal entity (corporation, partnership,
(21
3)
limited liability company, etc.) acquire a “controlling interest” (see
instructions for definition) in this business entity?
Yes
No
CAREFULLY READ AND FOLLOW THE ACCOMPANYING INSTRUCTIONS.
(2) If YES, did this business entity also own “real property” (see
instructions for definition) in California at the time of the
1.
If you no longer own this property as of January 1 of this year, show the name and mailing
acquisition?
address of the new owner:
Yes
No
Name
(3) If YES to both questions (1) and (2), filer must submit form BOE-
100-B, Statement of Change in Control and Ownership of Legal
Mailing Address
Entities, to the State Board of Equalization. See instructions for
filing requirements.
City and State
Zip Code
4.
Do any other individuals, partnerships or corporations do business or own personal property (other than household furniture and personal effects of your tenants) located on your
If yes, list below.
premises?
Yes
No
NATURE OF THE BUSINESS OR PROPERTY
NAME AND ADDRESS OF OWNER OF SUCH PROPERTY
If yes, list below.
5.
Do you hold furniture or equipment belonging to others on a loan, rental or lease basis?
Yes
No
NAME AND ADDRESS OF OWNER OF SUCH PROPERTY
QUANTITY AND DESCRIPTION
6.
ENTER BELOW the number of fully furnished, partly furnished (e.g., stoves and refrigerators, not built-in), and unfurnished units. Also complete
ASSESSOR’S
Schedule A. Do not include, either here or in Schedule A, any unit in which you live.
USE ONLY
SLP. ROOM
STUDIO
3 BEDRM.
1 BEDRM.
2 BEDRM.
LARGER
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.
.
FULLY FURNISHED
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.
.
2
6
2
3
2
5
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PARTLY FURNISHED
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2
6
2
3
2
5
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UNFURNISHED
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3
6
3
2
2
5
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TOTALS
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7
18
7
8
6
15
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$
7. Supplies
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Cost
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$
8. Furniture and appliances
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44
Enter From Schedule A
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$
9. Other furniture and equipment
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11
Enter From Schedule B
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10.
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TOTAL FULL VALUE
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ASSESSOR’S USE ONLY
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PERSONAL PROPERTY
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FIXTURES
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OTHER IMPROVEMENTS
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LAND
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DEPUTY:
DATE
ASSESSOR’S ESTIMATE
APPROVED BY:
DATE
BATCH NUMBER
TXN
21 3
*Agent: See 571-R INST (ASSR-525) for Declaration by Assessee instructions.
THIS STATEMENT SUBJECT TO AUDIT
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