2012 Business Tangible Property Return Form For Spotsylvania County - Virginia Commissioner Of Revenue
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32012 Business Tangible Property Return
Attn: Business Property Division
Deborah F Williams
for Spotsylvania County
Commissioner of Revenue
PO Box 175
Spotsylvania VA 22553- 0175
For assets used or available for use as of January 1, 2012
Phone: (540) 507-7051
Fax: (540) 582-7190
email: cor@spotsylvania.va.us
Account #
st
File by February 1
to avoid a late filing penalty.
Start Date (required)
Type of Business:
Sole Proprietor
Partnership
Corporation
LLC
Mailing Address: Block/Street Name:
City
State
Zip+4
Owner Name:
Physical Address: Block/Street Name:
City
State
Zip+4
Trade Name:
Social Security
Federal ID:
Contact Phone:
Business Phone:
Fax Number:
(for sole proprietors or partnerships)
Website:
Email:
Description of Business:
Attach itemized listing of all tangible property showing date of acquisition, date of disposal and original cost on the book basis.
This includes property that is fully depreciated or expensed for federal tax purposes. In the event there was no cost for acquisition,
please provide an estimate of fair market value at the time of acquisition.
All property must be substantiated through the following
documentation: Detailed listing of assets and/or equipment or Federal Form
4562.
A
B
C
Please see attached
Office Furniture & Fixtures
Heavy Construction
Manufacturing Equipment Only
instructions.
and other Equipment
(earthmovers or digging equipment)
(Machinery & Tools)
(excluding software)
Original Cost
Original Cost
Original Cost
Original Cost
Original Cost
Original Cost
Year of Acquisition
as of 1/1/11
as of 1/1/12
as of 1/1/11
as of 1/1/12
as of 1/1/11
as of 1/1/12
2011
$
$
$
$
$
$
2010
$
$
$
$
$
$
2009
$
$
$
$
$
$
2008
$
$
$
$
$
$
2007 & Prior
$
$
$
$
$
$
Total
$
Total
$
Total
$
0.00
0.00
0.00
If you own no business tangible, please check here
and provide explanation as to how your business is conducted
without the use of property.
_____________________________________________________________________________________________
Tangible Business Property Leased or Rented from Others (Attached additional sheet if necessary.)
Year Placed
Owner’s Name
Owner’s Address
Item Description
Cost
in Use
$
$
If the business has closed or sold, please provide the following:
Date Closed/Sold ____ /_____ / _____
New Owner’s Name:
Phone
(
)
Mailing Address:
City
State
Zip+4
Declaration:
I declare that the foregoing statement and cost amounts are true, complete, and correct to the best of my knowledge.
_________________________________________
___/ ___ /____
(_____) ___________________ ext ________
Signature
Date
Phone Number
_________________________________________
___/ ___ /____
(_____) ___________________ ext ________
Signature (person other than taxpayer preparing this return)
Date
Phone Number
(Online form – Rev 2/03/12)
Clear ALL Fields
Print Form
Keep a copy of this form for your records.
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