Form Dor 82520 - Arizona Business Property Statement - 2011
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1
2RETURN TO:
2011 ARIZONA
ASSESSOR’S USE ONLY
BUSINESS
PAMELA J. PEARSALL
PROPERTY STATEMENT
13
YAVAPAI COUNTY ASSESSOR
1015 FAIR STREET
PRESCOTT, AZ 86305
THIS STATEMENT IS CONFIDENTIAL AND
TAXPAYER / ACCOUNT NUMBER
LOC
CK
IS SUBJECT TO AUDIT BY THE ASSESSOR.
(928) 771-3220
FAX (928) 771-3181
FAILURE TO COMPLETE AND RETURN BY
THE REQUIRED DATE WILL RESULT IN
COMPLETE IN FULL AND RETURN TO ASSESSOR
A PENALTY OF TEN PERCENT OF THE
AMOUNT OF TAXES DUE, PURSUANT TO
APRIL 1, 2011
NEW TAXPAYER
BY:
A.R.S. § 42-15053(F)(2).
PROPERTY LOCATION:
MAILING DATE
AREA CODE:
01/28/11
PARCEL:
AREA CODE
BOOK
MAP
PARCEL
SPL
CK
DO NOT MAKE CHANGES IN ADDRESS AREA - SEE SECTION 1 BELOW
PRORATE
AP
10% PENALTY
IMPORTANT - READ FIRST! Before completing this form, please read the instructions
YES
for information on reporting requirements and the amount of exemption.
SIGN SECTION 6 TO CLAIM THE EXEMPTION.
SECTION 1: COMPLETE THIS SECTION ONLY IF THIS IS A NEW BUSINESS OR IF THERE IS A CHANGE IN NAME AND / OR ADDRESS.
1. BUSINESS NAME ___________________________________________ C / O ____________________________________________________________
2. ADDRESS ____________________________________________________________ CITY _____________________ STATE ______ ZIP ___________
3. PROPERTY LOCATION ADDRESS ________________________________________ CITY ____________________ STATE
AZ
ZIP ___________
4. BUSINESS TYPE (Manufacturing, Offi ce, Restaurant, etc.) ______________________________________ PRODUCT_____________________________
5. DATE STARTED IN THIS COUNTY ______________ CONTACT PERSON ___________________________________ PHONE ____________________
SECTION 2: DO NOT MAKE CORRECTIONS IN THIS SECTION. MAKE ALL CHANGES, ADDITIONS OR DELETIONS TO PROPERTY
COST LISTED BELOW IN SECTION 4. THE ACQUISITION COST OF PROPERTY REPORTED LAST YEAR IS LISTED BELOW BY
SCHEDULE AND YEAR ACQUIRED.
SCHED.
YEAR
ACQUISITION COST
CLASS
CODE
SCHED.
YEAR
ACQUISITION COST
CLASS
CODE
TAXPAYER: RETURN ORIGINAL FORM AND COPY BOTH SIDES FOR YOUR FILES
DOR 82520 (REVISED 11/2010)
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