Form Dor 82527 - Property Leased Or Rented From Inventory

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PROPERTY LEASED OR RENTED FROM INVENTORY
NOTE: SEE REVERSE SIDE FOR INSTRUCTIONS
Page: _____________ of _____________
1. Licensed Dealer
Sales Tax License Number
2. Mailing Address
3. Location of Business
Telephone Number
4. Reporting County
5. Month
Year
FOR ASSESSOR'S USE ONLY
6.
7.
8.
9.
11.
12.
13.
14.
10.
Equipment: Description
Suggested Retail
Number of Days
Location in
and Identification
Price or Acquisition
Removed From
*
County
Lessee
Number
Year Acquired
Cost
Inventory
Percent Good
Full Cash Value
Prorated Value
*
ARS §42-19005 requires all retailers or wholesalers who periodically lease or rent inventory to file an affidavit/report with the County Assessor. The report is to be
filed by the tenth day of each month for the preceding month's activity.
I CERTIFY THAT THE FOREGOING IS A TRUE AND CORRECT STATEMENT OF THE RECORDS IN MY CONTROL.
SIGNATURE
DATE
(
)
TYPE OR PRINT NAME
TELEPHONE NUMBER
DOR 82527 (Revised 5/01)

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