Form Boe-517-Pw (S1f) - Declaration Of Costs And Other Related Property Information - 2010

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BOE-517-PW (S1F) REv. 31 (12-09)
STATE OF CALIFORNIA
property statemeNt — iNtercouNty flumes, caNals,
BOARD OF EQUALIzATION
ditches, aQueducts
2010
declaratioN of costs aNd other related property iNformatioN
as of 12:01 a.m., JaNuary 1, 2010
This statement must be completed, signed, and filed with the State-Assessed Properties Division, Board of Equalization,
PO Box 942879, Sacramento, California 94279-0061, by March 1, 2010. Omit cents; round to the nearest dollar.
official reQuest
NAME, STREET, CITY, STATE and zIP CODE
This request is made in accordance with section 826 of the Revenue
and Taxation Code. This property statement must be completed
according to the instructions and filed with the Board of Equalization
(BOE) on or before March 1, 2010. If you do not file this statement,
you may be subject to the penalty provided in section 830 of the
Revenue and Taxation Code. Attached schedules are considered to
be part of the statement. THIS STATEMENT IS SUBJECT TO AUDIT.
SBE No.
make Necessary correctioNs to address label
Indicate if above is a change of name and/or address.
date
date to be
N/a
submitted
submitted
this statemeNt shall coNsist of:
(1) Dollar-Age Detail Report:
A. Fixed Equipment — BOE-533-PF
B. Continuous Pipeline — BOE-533-PP
C. Pipeline Mileage Report — BOE-575-P
(2) Statement of Land Changes — BOE-551
(3) Schedule of Intangible Information — BOE-529-I
(4) BOE-517-PW Schedules:
A. Comparative Balance Sheet
B. Plant and Equipment
C. Real Property Rentals
F. Sources and Uses of Water
H. Construction Work in Progress
(5) Schedule of Leased Equipment:
600-A
600-B
(6) Other information as requested:
A. Annual Report to Federal Agencies
B. Annual Report to State Agencies
C. Form 10K
D. Supplemental Information
Name aNd address of persoN to whom correspoNdeNce regardiNg audit should be addressed:
NAME
MAILING ADDRESS (including zip code)
TELEPHONE NUMBER
(
)
locatioN of accouNtiNg records:
ADDRESS (street, city, state, zip code)
NAME OF AUTHORIzED REPRESENTATIvE (if applicable) (BOE-892, Statement of Authorization, must be filed annually)
ADDRESS (street, city, state, zip code)
DAYTIME TELEPHONE NUMBER
(
)
certificatioN
I certify (or declare) under penalty of perjury under the laws of the State of California that I have examined this property statement, including accompanying schedules and
statements, and to the best of my knowledge and belief it is true, correct, and complete and covers all property required to be reported which is owned, claimed, possessed,
controlled, or managed by the person named in the statement at 12:01 a.m. on January 1, 2010. If prepared by a person other than the taxpayer, this declaration is based on
all information of which preparer has knowledge.
for official use oNly
FULL LEGAL NAME IF INCORPORATED
SIGNATURE OF OWNER, PARTNER, OFFICER, OR AUTHORIzED AGENT
DATE
2010
PRINTED NAME OF SIGNATORY
TITLE
SIGNATURE AND ADDRESS OF PREPARER OTHER THAN TAXPAYER
DATE
2010
iNformatioN proVided oN a property statemeNt may be shared with other state board of eQualiZatioN departmeNts
CONTINUE

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