Form 571-L - Business Property Statement - 2001 printable pdf download

571-L

2001

BUSINESS PROPERTY STATEMENT

assessor@co.la.ca.us

COUNTY OF LOS ANGELES

E-mail:

Web Site:

RICK AUERBACH, ASSESSOR

DECLARATION OF COSTS AND OTHER RELATED PROPERTY INFORMATION AS OF 12:01 A.M., JANUARY 1, 2001

Si desea ayuda en Espaαol, llame al nτmero (213) 974-3211.

RETURN THIS COPY

BY APRIL 1, 2001

COMPANY NUMBER

ROUTING

SITUS

ACCT FORM

AUDIT

P.C.

B.C.C.

ASSEMBLE WITH

NAME AND MAILING ADDRESS

Make necessary corrections to the printed name and mailing address)

(

TAX RATE

ASSESSOR'S IDENTIFICATION NUMBER

AREA

PAGE

MAP BOOK

PARCEL

LOCATION OF PROPERTY

(File a separate statement for each location)

GENERAL INFORMATION

COMPLETE (a) THRU (g) AS REQUESTED

PART I

RETAIN

g. During the period January 1, 2000 through December 31, 2000:

a. Enter type of business

TREND

(1) Has all or part of this real property been subject to a change

in ownership?

YES

b. Enter local telephone no. (

)

FAX no. (

)

(2) Are any related entities conducting business in the county?

OVERRIDE

YES

Do you own the land at this business location?

yes,

KILL BILL

provide name, mailing address, and locations:

is the name on your deed recorded

as shown on this statement?

YES

d. When did you start business at this location? DATE:

(3) If you leased this real property, has it been the subject of a

INACTIVE

If your business name or location has changed from last year,

lease agreement for a period of 35 years or more (including

enter the former name and/or location.

options)?

YES

DELETE

e. Enter location of general ledger and all related accounting records

(4) Did you acquire "control" through acquisition of stock or

(include ZIP):

otherwise of a legal entity which owns real property in this

A/C

county?

YES

f. Enter Name and Telephone Number of authorized person to contact

(5) Did another person or entity acquire "control" through

LEGEND

at location of accounting records.

acquisition of stock or otherwise of this corporation or

entity?

YES

PART II

DECLARATION OF PROPERTY BELONGING TO YOU

ASSESSOR'S USE ONLY

BILL#

COST

(attach schedule for any adjustment to cost)

(OMIT CENTS)

(SEE INSTRUCTIONS)

FULL CASH VALUE

1. SUPPLIES

2. EQUIPMENT

(From Line 38)

(Attach Schedule)

3. EQUIPMENT Out on Lease or Rent to Others.

TOTAL F.C.V.

FOR

(From Line 63)

4. BLDGS., BLDG. IMPR., and/or LEASEHOLD IMPR., LAND IMPR., LAND

5. CONSTRUCTION in PROGRESS

(Attach Schedule)

ESCAPE ASSM'T

(See instructions)

LESS FIXTURES

6. ALTERNATE SCHEDULE A

TYPE

CODE

PERSONAL PROP.

ADD

INTEREST

PART III

DECLARATION OF PROPERTY BELONGING TO OTHERS - IF NONE WRITE "NONE".

AFTER

(SPECIFY TYPE BY CODE NUMBER)

DESCRIPTION

721

YEAR

AND

Report conditional sales contracts on Schedule A.

COST TO

LF9

ANNUAL

LEASE OR

1. Leased Equipment

4. Vending Equipment

ACQ.

MFR.

PURCHASE

2. Lease-Purchase Option Equipment

5. Other Businesses

IDENTIFICATION

RENT

3. Capitalized Leased Equipment

6. Government-Owned Property

NEW

NUMBER

APPLY 10% PEN

Tax Obligation: A. Lessor B. Lessee

9. Lessor's Name

Mailing Address

10. Lessor's Name

Mailing Address

DEPUTY

CERTIFICATION

OWNERSHIP TYPE ( )

I certify (or declare) under penalty of perjury under the laws of the State of California that I have examined this return, including accompanying schedules and statements,

Proprietorship

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,

DATE

or managed by the person named in the statement at 12:01 a.m. on January 1, 2001. If prepared by a duly authorized person other than the taxpayer, the declaration is

Partnership

This declaration is binding

based on all information of which the preparer has knowledge. This statement must be signed. Failure to do so could result in penalties.

on each and every co-owner and/or partner.

Corporation

NAME OF ASSESSEE OR AUTHORIZED AGENT

TITLE

(typed or printed)

APPROVAL

Other

DATE

SIGNATURE OF ASSESSEE OR AUTHORIZED AGENT