Form 5653pbpl-2 - Business Personal Property Listing Form - Guilford County - 2010 Page 3

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TWP
RC
(3)
NAME:
DBA:
SCHEDULE F -
INTANGIBLE PERSONAL PROPERTY
LIST ALL LEASES OR RENTALS OF REAL PROPERTY FROM EXEMPT OWNERS SUCH AS THE LOCAL, STATE, OR FEDERAL GOVERNMENT, AN AIRPORT AUTHORITY, UNIVERSITY OR CHURCH.
LIST SOFTWARE IN SCHEDULE B.
DATE OF
MONTHLY
LENGTH
NAME AND ADDRESS OF OWNER
DESCRIPTION OF PROPERTY
ACCOUNT OR LEASE NUMBER
LEASE
PAYMENT
OF LEASE
SCHEDULE G -
PROPERTY OWNED BY OTHERS IN YOUR POSSESSION ON JANUARY 1
LIST ALL BUSINESS PERSONAL PROPERTY IN YOUR POSSESSION ON JANUARY 1 THAT IS OWNED BY OTHERS. THIS INCLUDES ALL EQUIPMENT LEASED, LOANED, OR OTHERWISE HELD.
GIVE THE OWNER’S NAME AND ADDRESS, A DESCRIPTION OF THE PROPERTY, LEASE INFORMATION IF ANY, AND SELLING PRICE NEW, ATTACH SEPARATE SCHEDULE IF NECESSARY.
GROUP (1) EQUIPMENT OWNED BY OTHERS IN YOUR POSSESSION JANUARY 1.
DATE OF
MONTHLY
LENGTH
ACCOUNT OR
SELLING PRICE
NAME AND ADDRESS OF OWNER
DESCRIPTION OF PROPERTY
LEASE
PAYMENT
OF LEASE
LEASE NUMBER
NEW
GROUP (2) - MOTOR VEHICLES, TRAILERS, OR AIRCRAFT OWNED BY OTHERS IN YOUR POSSESSION ON JANUARY 1.
LIST BELOW ALL MOTOR VEHICLES AND TRAILERS NOT REGISTERED IN NORTH CAROLINA AND ALL AIRCRAFT OWNED BY OTHERS THAT WERE IN YOUR POSSESSION ON JANUARY 1.
LIST BODY OR SPECIAL EQUIP-
NAME AND ADDRESS
VEHICLE IDENTIFICATION NUMBER, LICENSE PLATE,
DATE OF
SELLING PRICE
YEAR
MAKE
MENT MOUNTED ON TRUCKS
OF OWNER
STATE OF REGISTRATION
LEASE
NEW
SEPARATELY @ 100% COST
SCHEDULE H - FARM TRACTORS
LIST ALL TRACTORS, ALL OTHER FARM EQUIPMENT SHOULD BE LISTED ON SCHEDULE I.
GAS
YEAR
100% OF
DEPARTMENT
YEAR
MAKE
MODEL OR SERIES
OR DIESEL
PURCHASED
ORIGINAL COST
USE ONLY
SCHEDULE I - FARM IMPLEMENTS, MACHINERY AND EQUIPMENT, BULK BARNS
LIST ALL FARM EQUIPMENT (EXCLUDING THE TRACTORS LISTED ABOVE) AT 100% COST BY YEAR OF ACQUISITION INCLUDING ALL FULLY DEPRECIATED
ASSETS INCLUDING CIP IN YOUR POSSESSION AS OF JANUARY 1. ATTACH SEPARATE SCHEDULE IF NECESSARY.
YEAR OF
MACHINERY &
OFFICE FURNITURE
BULK BARNS
TOTAL
EQUIPMENT
& EQUIPMENT
DEPARTMENT USE ONLY
ACQUISITION
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
PRIOR
TOTAL
100% COST OF ALL OTHER EQUIP AND SUPPLIES AS OF JAN.1 NOT INCLUDED IN SCHED A, H, OR 1 (ITEMIZE & ATTACH SEPARATE SCHEDULE)
A COPY OF YOUR LATEST BALANCE SHEET AND DEPRECIATION SCHEDULE
OR FIXED ASSETS LEDGER SHOULD ACCOMPANY THIS RETURN
ALL SECTIONS OF THIS RETURN MUST BE COMPLETED PER INSTRUCTIONS OR IT WILL BE REJECTED
IF A SECTION DOES NOT APPLY, INDICATE SO, DO NOT LEAVE BLANK

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