Form 921-97 - Ohio Balance Sheet
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1921-97
State of Ohio
O
B
S
Prescribed by the
HIO
ALANCE
HEET
___________
Tax Commissioner
Return Year
Name ____________________________________________ FEIN/Social Security No. ________________________________
Address __________________________________________ Ohio Charter/License No. _______________________________
City __________________________________________________________ State _______________ Zip __________________
Balance Sheet as of _____________________________
Within Ohio
Total
Assets
Net Book Values
Net Book Values
1. Cash and Deposits .........................................................................
2. Notes and Accounts Receivable ...................................................
3. Inventories ......................................................................................
4. Investments ....................................................................................
5. Land ................................................................................................
Ohio Cost
6. Buildings
A) Taxed as Real Estate .........................................
B) Taxed as Personal Property ...............................
7. Leasehold Improvements
A) Taxed as Real Estate .........................................
B) Taxed as Personal Property ...............................
8. Machinery & Equipment
A) Taxed as Real Estate .........................................
B) Taxed as Personal Property ...............................
9. Furniture & Fixtures ...............................................
10. Personal Property Leased to Others
A) Taxable ..............................................................
B) Non-Taxable ......................................................
11. Capitalized Leases .................................................
12. Personal Property located in an Urban
Job Enterprise Zone ..............................................
13. Certified Exempt Facilities ....................................
14. Patterns, Jigs, Dies & Drawings ...........................
15. Construction in Progress
A) Real Property .....................................................
B) Personal Property Capable of Use .....................
C) Personal Property Not Capable of Use ..............
16. Small Tools .............................................................
17. Vehicles & Aircraft
A) Registered or Leased ........................................
B) Other .................................................................
18. Other Assets ...................................................................................
..................................................................................................
19. Total Assets ....................................................................................
Liabilities and Net Worth
Total
20. Notes, Accounts Payable, Bonds and Mortgages ...............................................................
21. Accrued Expenses .................................................................................................................
22. Other Liabilities, Deferred Credits ........................................................................................
23. Preferred Stock ......................................................................................................................
24. Common Stock ......................................................................................................................
25. Additional Paid-In Capital ......................................................................................................
26. Retained Earnings .................................................................................................................
27. Appropriated Earnings ..........................................................................................................
28. Owner's Capital ......................................................................................................................
29. Other .......................................................................................................................................
30. Total Liabilities & Net Worth .................................................................................................
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