Form 150-302-121 - Annual Statement For Regulated Electric Companies Form - 2008
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1Department of Revenue Use Only
Post Marked Date
Date Received
ANNUAL STATEMENT*
Extension Date
for Regulated Electric Companies
MUST BE POSTMARKED BY MARCH 17, 2008
DECLARATION OF PROPERTY COST, OPERATIONS AND OTHER RELATED INFORMATION AS OF
January 1, 2008
Business Name
Business E-mail Address or Web Site Address
Street Address
Is this a change of address?
Yes
No
City
State
ZIP Code
STATEMENT REQUIRED
Oregon law (ORS 308.520) requires that each company assessed by the Department of Revenue file an annual statement
with the department on or before March 17. Failure to file a complete statement will subject the company to a late filing
THIS STATEMENT IS SUBJECT TO AUDIT.
penalty (ORS 308.030).
CONTACT PERSON FOR ANNUAL STATEMENT
Name
Telephone Number
Mailing Address
Fax Number
City
State
ZIP Code
CONTACT PERSON AND MAILING ADDRESS FOR TAX STATEMENTS
Name
Telephone Number
Mailing Address
E-mail Address
City
State
ZIP Code
TAXPAYER DECLARATION
I declare under penalties of false swearing [ORS 305.990(4)] that this statement, including attached schedules, has been examined by
me and to the best of my knowledge and belief, is true, correct, and complete.
Full Legal Name (if incorporated)
Owner is (indicate where individual, partnership, corporation, etc.)
Signature of owner, officer or authorized agent
Date
X
Typed or printed name of officer or agent signing above
Title
Name of Preparer (if other than taxpayer)
Telephone Number
I authorize the exchange of confidential information for this return, via e-mail to the e-mail address above.
Signature & Title of Owner, Officer or Authorized Agent
Title
Valuation Section
MAIL COMPLETED STATEMENT AND SCHEDULES TO:
Property Tax Division
Oregon Department of Revenue
PO Box 14600
Salem OR 97309-5075
Be sure to read the instructions on the previous sheet
*This form has been updated since the original mailing,
either form is acceptable.
150-302-121 (Rev. 02-08) (P-35)
Regulated electric, page 1 of 22
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