Form B-116 - Supplemental Schedule To Form 571-L For Service Station And/or Car Wash - 2017 Page 2
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2COUNTY OF LOS ANGELES • OFFICE OF THE ASSESSOR
500 WEST TEMPLE STREET • 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
INSTRUCTIONS
PLEASE READ ALL INSTRUCTIONS ACCOMPANYING FORM 571-L PRIOR TO
COMPLETING THIS SUPPLEMENTAL SCHEDULE
COST DETAIL: EQUIPMENT
GENERAL INFORMATION
LINES 1-24
This supplemental schedule for SERVICE
STATION AND/OR CAR WASH is required to
For service station equipment in categories
be filed for reporting your service station and/
(1), (2), and (3), enter on each applicable
or car wash equipment. You are instructed
line the description, size or capacity, the
to use this schedule, designed for your
number of units, acquisition date, and cost of
specific business, to report the requested
acquisition. Include equipment expensed and
information.
fully depreciated items. Include excise, sales
and use taxes, freight-in, installation charges
REPORT COST OF OFFICE FURNITURE
and all other relevant costs. Attach additional
AND EQUIPMENT, NON-PRODUCTION
schedules as needed. Enter the total cost
COMPUTERS, AND TOOLS USED IN YOUR
of each category on the appropriate lines (8,
BUSINESS ON SCHEDULE A, PAGE (P2)
17, or 23). Add the totals on lines 8, 17, 23,
OF FORM 571-L. REPORT ALL BUILDING
and any additional schedules and enter the
OR LEASEHOLD IMPROVEMENTS ON
total on line 24.
SCHEDULE B, PAGE (P2) OF FORM
571-L. ALSO, REPORT THE COST OF CAR
LINES 25-43
WASH PROCESS PLUMBING AND CAR
WASH PROCESS WIRING IN COLUMN 2 OF
Complete lines 25 through 42 for categories
SCHEDULE B.
(4), (5), (6) and (7). Attach additional
schedules as needed. Line 42 “Prior” —
Attach this supplemental schedule to your
report detail by year(s) of acquisition on a
corresponding Form 571-L. Other schedules
separate schedule. Enter the total cost of
may be submitted and attached to Form
each category on line 43.
571-L to report additional information, which
will assist the Assessor in determining the fair
LINE 44
market value.
Add the total on line 24 and all totals on line
If additional information is needed, please
43 and enter the sum on line 44 and on line
contact the Assessor’s office cited on the
6, Part II, page (P1) of the preprinted Form
face of your Form 571-L.
571-L.
NAME
OTHER INFORMATION
Enter the name of assessee as shown on the
In the space provided below, enter the date,
front of the preprinted Form 571-L.
total cost, and reason(s) for any construction
performed on the underground tank(s) after
LOCATION OF PROPERTY
September 7, 1999. You may be requested
to provide additional information as needed
Enter the location of property as shown on
by the Assessor.
the front of the preprinted Form 571-L. If no
location is shown, enter the correct street
address, city, and ZIP code where your
property is located.
Details of construction performed on underground tank(s) after 9-7-1999: (Attach schedules as needed.)
Date
Total Cost of Construction
Reason for Construction
B-116A (BACK) (REV. 9-16)
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