Form 571-L - Business Property Statement - 2000

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SACRAMENTO COUNTY
Business Property Statement
K
.
,
ENNETH D
STIEGER
ASSESSOR
700 H Street, Room 6720
DECLARATION OF COSTS AND OTHER RELATED PROPERTY
Sacramento CA 95814-1284
INFORMATION AS OF 12:01 A.M. JANUARY 1, 2000
Telephone (916) 874-5211
Fax (916) 874-7625
FILE ON OR BEFORE APRIL 1, 2000
(File a separate statement for each location)
(Make necessary corrections of the printed name and mailing address)
PART I GENERAL INFORMATION
Complete (a) through (g) as requested.
f. Enter name and telephone no. of authorized person to contact at location of accounting
a. Enter type of business
records
b. Enter local telephone No. (
)
g. During the period of January 1, 1999 through December 31, 1999:
YES
NO
YES
NO
(1)
c. Do you own the LAND at this business location?
?
Has all or part of this REAL property been subject to a change in ownership
YES
NO
YES
NO
(2)
YES
NO
If YES, is the name on your deed recorded as shown on this statement?
Are any related entities conducting business in the county?
YES
NO
d. When did you start business at this location? DATE:
If yes, provide name, mailing address and locations.
If your business name or location has changed from last year, enter the former name
(3)
and/or location
If you leased this real property, has it been the subject of a lease agreement
YES
NO
for a period of 35 years or more (including options)?
(4)
e. Enter location of general ledger and all related accounting records (include zipcode).
Did you acquire “control” through acquisition of stock or otherwise of a legal
YES
NO
entity which owns real property in this county?
(5)
Did another person or entity acquire “control” through acquisition of stock or
YES
NO
otherwise of this corporation or entity?
PART II DECLARATION OF PROPERTY BELONGING TO YOU
COST
ASSESSOR’S USE ONLY
(OMIT CENTS)
(Attach Schedule For Any Adjustment To Cost)
SEE INSTRUCTIONS
FULL VALUE
TOTAL VALUE
FIXTURES
1. Supplies
2. Equipment
(From Line 35)
3. Equipment Out on Lease or Rent to Others
(Attach Schedule)
PERSONAL PROPERTY
4. Bldgs., Bldg. Impr., and/or Leasehold Impr., Land Impr., Land
(From Line 71)
5. Construction in Progress
(Attach Schedule)
6. Alternate Schedule A
See Instructions
EXEMPTION
7.
8.
ASSESSMENT TYPE
PRIOR YEAR FIX
PRIOR YEAR PERS.
PART III
DECLARATION OF PROPERTY BELONGING TO OTHERS
IF NONE, WRITE “NONE”
(SPECIFY TYPE BY CODE NUMBER)
Year
Year
Cost to
Report conditional sales contracts on Schedule A
of
of
Description and Lease or
Annual
Purchase
1. Leased Equipment
4. Vending Equipment
Acq.
Mfr.
Identification Number
Rent
New
2. Lease-Purchase Option Equipment
5. Other Businesses
3. Capitalized Lease Equipment
6. Government - Owned Property
Tax Obligation:
A. Lessor
B. Lessee
9.
Lessor’s Name
Mailing Address
10. Lessor’s Name
Mailing Address
CERTIFICATION
PROCESSING DATA
OWNERSHIP
I certify (or declare) under penalty of perjury under the laws of the State of California that I have examined this return, including accompanying
TYPE
( )
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 re-
ported which is owned, claimed, possessed, controlled, or managed by the person named in the statement at 12:01 a.m. on January 1, 2000. If
Proprietorship
By:
prepared by a duly authorized person other than the taxpayer, the declaration is based on all information of which the preparer has knowledge. This
Partnership
statement must be signed. Failure to do so could result in penalties.
Corporation
Date:
Other
Full Legal Name
Federal Employer ID#
Com-
BUSINESS
DESCRIPTION
Signature of Owner, Partner, Officer, or Legal Agent*
Date
( )
Reviewed:
Retail
Wholesale
Printed name of Owner, Partner, Officer, or Legal Agent*
Title
Billed:
Manufacturer
Service/Prof.
Signature of Preparer (Other than Taxpayer*)
Telephone Number
Date
Verified:
*The owner’s written authorization of the agent/preparer must be filed with the assessor.
BOE 571-L (S1F) Rev. 4 (6/99)
1
Additional copies of this form available on request.

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