Tax Form 921 - Ohio Balance Sheet - 2002
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1
2Tax Form
O
B
S
2002
921
HIO
ALANCE
HEET
(Required to be Filed with Tax Form 945)
Prescribed by the
Tax Commissioner
Name __________________________________ FEIN/Social Security No. _________________
Balance Sheet as of ________________________ 2001
Within Ohio
Total
Assets
Net Book Values
Net Book Values
1. Cash and Deposits .........................................................................
2. Notes and Accounts Receivable ...................................................
3. Inventories
A) Manufacturing ............................................................................
B) Merchandising ...........................................................................
–
C) Supplies
Manufacturing ............................................................
–
D) Supplies
Other ..........................................................................
E) Consigned .................................................................................
F) Agricultural Machinery & Equipment (Merchandise) ..................
G) Exempted Inventory ...................................................................
H) Other Inventory ..........................................................................
4. Investments ....................................................................................
5. Land ................................................................................................
Ohio Cost
6. Buildings
A) Taxed as Real Estate .........................................
B) Taxed as Personal Property ...............................
7. Leasehold Improvements
A) Taxed as Real Estate .........................................
B) Taxed as Personal Property ...............................
8. Machinery & Equipment
A) Taxed as Real Estate .........................................
B) Taxed as Personal Property ...............................
9. Furniture & Fixtures ...............................................
10. Personal Property Leased to Others
A) Taxable ..............................................................
B) Non-Taxable ......................................................
11. Capitalized Leases .................................................
12. Exempt Personal Property located in an:
Enterprise Zone (Attach Form 913EX), or
Hazardous Substance Reclamation Area .............
13. Certified Exempt Facilities ....................................
14. Patterns, Jigs, Dies & Drawings ...........................
15. Construction in Progress
A) Real Property .....................................................
B) Personal Property Capable of Use .....................
C) Personal Property Not Capable of Use ..............
16. Small Tools .............................................................
17. Vehicles & Aircraft
A) Registered or Licensed ......................................
B) Other .................................................................
18. Other Assets ...................................................................................
..................................................................................................
19. Total Assets ....................................................................................
Liabilities and Net Worth
20. Notes, Accounts Payable, Bonds and Mortgages ...............................................................
21. Accrued Expenses .................................................................................................................
22. Other Liabilities, Deferred Credits ........................................................................................
23. Preferred Stock ......................................................................................................................
24. Common Stock ......................................................................................................................
25. Additional Paid-In Capital ......................................................................................................
26. Retained Earnings .................................................................................................................
27. Appropriated Earnings ..........................................................................................................
28. Owner's Capital ......................................................................................................................
29. Other .......................................................................................................................................
30. Total Liabilities & Net Worth .................................................................................................
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