APARTMENT INCOME & EXPENSE REPORT
DUE DATE: April 15, 2014
Reporting Period January 1, 2013 to December 31, 2013
Complete this report in accordance with accounting methodologies used for Federal Income Tax reporting.
DC Code §47-821 stipulates that all information contained in this report shall be kept in strict confidence.
Failure to submit complete and accurate information requested by the above date is a violation
of DC Code and will result in a ten percent penalty of taxes due assessed to your following year
tax bill.
Government of the District of Columbia
Office of the Chief Financial Officer
Office of Tax and Revenue
th
1101 4
Street, SW, Suite W550
Washington, DC 20024
Square Suffix Lot
Apartment Name
Premise Address
If your operation encompasses more than one Square, Suffix and Lot (SSL), you may list additional SSLs below. This
will afford you filing credit for the parcels within the economic unit without the necessity of filing individual forms.
Owner:
Address:
Address:
City:
State:
Zip:
CERTIFICATION
I certify under penalty of law that the information provided is true, correct and complete to the best of my knowledge
and belief. Making a false statement as to material facts is punishable by criminal penalties, D.C. Code §22‐2514
Management Company:
Title/Relationship:
Responsible Contact Person:
Phone:
Address
State:
Zip:
Date:
Contact Person E‐mail:
Owner’s EIN#:
Type Name
Signature