Form Dor 82520 - Arizona Business Property Statement - Pinal County Assessor - 2012
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1
2L PAUL LARKIN
ASSESSOR’S USE ONLY
PINAL COUNTY ASSESSOR
2012 ARIZONA
PO BOX 709
BUSINESS
FLORENCE AZ 85132-0709
PROPERTY STATEMENT
COMPLETE IN FULL AND RETURN TO ASSESSOR
TAXPAYER/ACCOUNT NUMBER
LOC
CK
APRIL 1, 2012
THIS STATEMENT IS CONFIDENTIAL
BY:
AND IS SUBJECT TO AUDIT BY THE
NEW TAXPAYER
ASSESSOR. FAILURE TO
MAILING DATE
COMPLETE AND RETURN BY THE
02/01/2012
REQUIRED DATE WILL RESULT IN A
PENALTY OF 10%OF THE TAXES
AREA CODE
PROPERTY LOCATION
§
:
DUE, PURSUANT TO A.R.S.
42-
15053(F)(2).
BOOK
MAP
PARCEL
SPL
CK
PRORATE
AP
10% penalty
YES
DO NOT MAKE CHANGES IN ADDRESS AREA- SEE SECTION 1 BELOW
IMPORTANT – READ FIRST! Before completing this form, please read the instructions
for information on reporting requirements and the amount of exemption.
SIGN SECTION 6 TO CLAIM 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 ______ ZIP ____________
4. BUSINESS TYPE (MANUFACTURING, OFFICE, 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
SCHED.
YEAR
ACQUISITION COST
CLASS
CODE
YEAR
ACQUISITION COST
CLASS
CODE
.
TAX PAYER: RETURN ORIGINAL FORM AND COPY BOTH SIDES FOR YOUR FILES
DOR 82520 (REVISED 11/2010)
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