Form 150-553-004 - Confidential Personal Property Return - 2012

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2012
Confidential Personal Property Return
2012
(ORS 308.290)
Assessment of Business Furniture/Fixtures/Equipment/Floating Property
Filing Deadline: March 1, 2012
PENALTY—
Maximum penalty for late filing of personal property return is up to 50 percent
of the tax attributable to the taxable personal property. (ORS 308.296)
Clear Form
Account Number
Code Area
FOR ASSESSOR’S USE ONLY
1. Leased or Rented Property
2. Noninventory Supplies
3. Floating Property
4. Libraries
5. All Other Property
6.
7. Total Real Market Value
8. Late Filing Penalty
Make any name or mailing address corrections above. Date changed _______________
TAXPAYER’S DECLARATION
Invalid if not signed. Under the penalties described in ORS 305.990(4),
This Return is Subject to Audit
I affirm that I have examined this return and all attachments. All
statements made are true. To the best of my knowledge, all taxable
Location of Personal Property on January 1, 2012.
personal property I own, possess, or control, which was in this county
File a separate return for each tax code area (or location). Attach a separate listing if needed.
as of 1:00
.
., January 1 has been reported.
a
m
Name of firm/owner
Personal property location (street address, city)
E-mail address
Date business originated in county
Type of business
Assumed business name of firm assessed
Telephone no.
Was a return filed last year?
Yes County __________________
No
(
)
Mailing address
Fax no.
First Time Filer
(See General Information, No. 1)
(
)
City
State
ZIP code
If your assessment was cancelled, see General Information, No. 2
Signature of person responsible for return
Date
Remember to sign the Taxpayer’s Declaration at right
X
Printed name of person signing return
Title
No Personal Property to Report
(See General Information, No. 3)
Business closed?
Moved out of county?
Phone
Person completing return
Date closed:
Date moved:
New address:
Business sold?
THIS RETURN IS BEING FILED FOR:
Date of sale:
An Individual
A Partnership
(No. of persons ____)
Name and address of new owner
(if business sold)
A Corporation
A Limited Partnership
A Limited Liability Company
A Limited Liability Partnership
May we forward the current property list to new owner?
Yes
No
Attach a separate list of names and addresses of each individual partner
Signature:
for corporations, LLCs, LLPs, and partnerships.
Multiple Locations Within This County
(See General Information, No. 6)
Business Name:______________________________________________ Business Location: ______________________________________________
Business Name:______________________________________________ Business Location: ______________________________________________
Extension Number
______________________________
(See General Information, No. 5)
Logging Exemption in Previous Year
Logging Exemption in
______________________
County
(See General Information, No. 4)
Submit your original return and attachments to your county assessor. Keep a photocopy and the attached instructions for your records.
SCHEDULE 1— LEASED OR RENTED PERSONAL PROPERTY
(Do not report real property. Enter “None” if no personal property to report)
3
1
2
Payer of
6
7
8
9
10
11
Name and Address of
Date
Length
Owner’s Opinion of
AMOUNT OF
Original Cost
Assessor’s
Taxes to County
Agree-
of
No.
LEASE/RENT
Market Value
Second Party Involved
Description
RMV
of
ment
Agree-
4
5
In Lease/Rent Agreement
(Include model year)
Each
Total
TOTAL
(leave blank)
Lessor Lessee
Month Yearly
Began
Units
ment
If Schedule 1 items are reported on separate attachments, check here:
Schedule 1 TOTAL:
(Include attachments)
Remember: The filing deadline for this return is March 1, 2012
150-553-004 (Rev. 10-11)
1

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