Form Dor 82520a-I - Agricultural Business Property Statement - 2012 Page 4

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2012 ARIZONA AGRICULTURAL BUSINESS PROPERTY STATEMENT
SHADED AREAS FOR ASSESSOR’S USE ONLY
FARM OR RANCH NAME _____________________________________________________________ TAXPAYER / ACCOUNT NUMBER __________________
SECTION 3:
CLASS
CLASS
CLASS
CLASS
CLASS
CLASS
CLASS
CLASS
CLASS
ASSESSOR’S
A
B
C
D
E
L
G
J
N
USE
TBL #
LIFE
TBL #
LIFE
TBL #
LIFE
TBL #
LIFE
TBL #
LIFE
TBL #
LIFE
TBL #
LIFE
TBL #
LIFE
TBL #
LIFE
ONLY
SECTION 4:
ADDITIONS AND DELETIONS: ENTER YOUR ACQUISITION COST IN THE APPROPRIATE SCHEDULE FOR PROPERTY ACQUIRED DURING THE PRIOR YEAR
WHICH YOU OWNED ON 12/31/2011. ENTER YOUR ACQUISITION COST IN THE APPROPRIATE SCHEDULE AND THE YEAR OF ACQUISITION FOR ALL
PROPERTY DELETED DURING THE PRIOR YEAR.
A
B
C
D
E
G
J
L
N
SCHEDULE
YEAR OF
OFFICE
SADDLES AND
MACHINERY AND
SUPPLIES
COPYING
MACHINERY AND
FURNITURE
LASER
DAIRY
COMPUTER
HAND TOOLS
ADDITIONS OR
EQUIPMENT NOT
ON HAND
EQUIPMENT
EQUIPMENT
AND
EQUIPMENT
EQUIPMENT
CONTROLS
ON HAND
SELF-PROPELLED
SELF-PROPELLED
DECEMBER 31
DELETIONS
EQUIPMENT
DECEMBER 31
ADDITIONS:
YEAR
Qualified
Non-Qualified
Qualified
Non-Qualified
DELETIONS:
YEAR
20 ______
20 ______
20 ______
20 ______
20 ______
ACQUISITION
ADDITION OR
TABLE
ACQUISITION
YEAR
DESCRIPTION
COST
DELETION
NO.
LIFE
Qualified
Non-Qualified
SCHEDULE F: OTHER PROPERTY
Qualified
SCHEDULE H: LEASEHOLD
Non-Qualified
IMPROVEMENT
SCHEDULE M: TAXABLE ANIMALS AND LIVESTOCK (SEE INSTRUCTIONS BEFORE COMPLETING)
QUANTITY
QUANTITY
DESCRIPTION
ON 12/31
CODE
DESCRIPTION
ON 12/31
CODE
SECTION 5: ADDITIONAL INFORMATION REQUIRED.
LEASED OR RENTED PROPERTY: Attach a list of all leased or rented property in your possession.
UNOWNED PROPERTY: Attach a list of property located at your place of business which you do not own, lease, or rent.
GOVERNMENT OWNED LAND: If located on government property, attach a list providing the governmental owner’s name and address.
SECTION 6: AFFIRMATION OF PROPERTY STATEMENT AND CLAIM OF EXEMPTION
By signing below, I hereby affirm that this is a full, true, and complete statement of property that is claimed by, or that is in the possession or control of the
undersigned, and it is verifiable from records and files of the above named business. The person whose signature is affixed below likewise claims an
exemption amount not to exceed the first $68,079 of full cash value. Each eligible taxpayer is entitled to one statewide exemption.
_________________________________________________
______________________
___________________________________________
Print Name of Property Owner or Authorized Agent
Date
Name of County in which you are Claiming Exemption
_________________________________________________
______________________
Signature of Property Owner or Authorized Agent
Phone
SUPPLEMENTAL INFORMATION ATTACHED: YES
NO
TAXPAYER RETURN ORIGINAL FORM AND COPY BOTH SIDES FOR YOUR FILES

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