Business Assessment List Form - Stone County, Missouri - 2016 Page 2
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1
2e.g. Auto, Truck, Tractor,
Ford F-150, etc.
LE
Crew
2-Dr
2WD
MODEL
VEHICLE / EQUIP. TYPE:
MAKE & MODEL
STYLE
# DRS
DRV
CAB
GVW /
# AXLES
LENGTH:
MO MILES
TOTAL
OFFICE USE
Trailer, Etc.
Ext.
4-Dr
4WD
YEAR
TONS
TRAILERS
MILES
ONLY
Sngl.
DESCRIPTION
Y
E
A
R
MAKE
M
O
D
E
L
4
X
4
H
P
ENGINE (circle)
ORIG. COST
$
FORKLIFTS
YES
NO
Gas
Diesel
$
BACKHOES
Gas
Diesel
YES
NO
$
HEAVY
DOZERS
Gas
Diesel
YES
NO
EQUIPMENT
$
DRILLING EQUIPMENT
YES
NO
Gas
Diesel
$
O
THER CONST. EQUIP.
Gas
Diesel
YES
NO
$
TRACTOR
YES
NO
Gas
Diesel
$
BRUSH HOG
YES
NO
Gas
Diesel
Attach additional sheet if necessary.
LIVESTOCK
TYPE
NO.
TYPE
NO.
TYPE
NO.
CALVES (0-11 mo.)
PIGS (0-120 lb.)
GOATS
COWS / BULLS (2+ yrs.)
BARROWS
DOGS (NOT PETS)
YEARLINGS (1 - 2 yrs.)
ASSES / JENNIES / MULES
LLAMA/ALPACA
LAMBS / SHEEP
SOWS / BOARS
OTHER LIVESTOCK
HORSES (2+ yrs.)
POULTRY
COLTS (1 - 2 yrs.)
EMU / OSTRICH
SLEEPERS / KITCHENETTES / HOTELS / MOTEL ROOMS
ASSESSOR
QUANTITY:
QUANTITY:
(Circle)
(Circle)
HULL MTL.
MOTOR TYPE
BOATS / WATERCRAFT
YEAR
MAKE
MODEL
LENGTH
HP
HULL ID / SERIAL NUMBER
OFFICE USE
FIBERGLASS
OUTBOARD
BASS BOAT
ALUM.
WOOD
I/O INBOARD
BASS BOAT
PONTOON BOAT
PONTOON BOAT
HOUSEBOAT / CRUISER
HOUSEBOAT / CRUISER
MISC. BOAT
MISC. BOAT
I / O BOAT / DECK BOAT
I / O BOAT / DECK BOAT
MOTORS
MOTORS
PERSONAL WATERCRAFT
PERSONAL WATERCRAFT
1
2
BOAT DOCK (PERMIT NO.)
BOAT DOCK (PERMIT NO.)
YEAR BUILT
LENGTH
WIDTH
YEAR BUILT
LENGTH
WIDTH
BOAT LIFT
BOAT LIFT
AIRPLANE
YEAR
MAKE
MODEL / TYPE
HR. / LAST YR.
MAX CERT.GROSS TAKEOFF WT.
PURCHASE
ASSESSOR
AGENT OR PREPARER'S INFORMATION
NAME
ADDRESS
CITY, STATE, ZIP CODE
TELEPHONE
TAX I.D. NUMBER
(
)
I, _____________________________________________________ ,
President
Treasurer
Owner
Manager
Other __________________________
of ______________________________________________________ , do solemnly swear, or affirm, that the foregoing list contains a true and correct statement of
all the tangible personal property, made taxable by the laws of the state of Missouri, which I owned or which I had under my charge or management on the first
day of January. I further solemnly swear, or affirm, that I have not sent or taken, or caused to be sent or taken, any property out of this state to avoid taxation.
So help me God.
Signed _______________________________________________________ Date___________________
I have listed additional property on sheet attached.
Failure to return your Assessment List will result in a Penalty:
ASSESSED VALUE
PENALTY
ASSESSED VALUE
PENALTY
Late personal Property Lists – Sec. 137.280 RSMO states, in part, if any taxpayer neglects or refuses to deliver, by
0 – $1,000
$10
$5,001 – $6,000
$60
MARCH 1, an itemized statement or list of all the taxable tangible personal property signed and certified by the taxpayer,
$1,001 – $2,000
$20
$6,001 – $7,000
$70
the owner of the property which ought to have been listed shall be assessed a PENALTY based on the assessed value
$2,001 – $3,000
$30
$7,001 – $8,000
$80
of the property that was not reported as follows:
$3,001 – $4,000
$40
$8,001 – $9,000
$90
$4,001 – $5,000
$50
$9,001 and above
$100
SECTION 137.285 PROVIDES FOR DOUBLING OF YOUR ASSESSMENT IF YOU FILE A FRAUDULENT LIST.
104B
STON2-102 (Rev 10/15)
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