Form 62a500 - C - Consignee Tangible Personal Property Tax Return

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62A500 - C (11-15)
FOR OFFICIAL USE ONLY
County Code
Locator Number
Commonwealth of Kentucky
CONSIGNEE TANGIBLE PERSONAL
T
DEPARTMENT OF REVENUE
/
Office of Property Valuation
PROPERTY TAX RETURN
Division of State Valuation, ST 32
(For Informational Purposes Only)
MAY 2016
Due Date:
Property Assessed January 1, 2016
Monday
S
M
T
W
T
F
S
May 16, 2016
1
2
3
4
5
6
7
Recommended for forms filed on or before due date to:
See pages 11 and 12 for a complete list
8
9
10 11 12 13 14
of mailing addresses.
File this return with the PVA in the county of taxable situs.
15 16 17 18 19 20 21
16
Returns filed after due date with the Office of Property Valuation.
22 23 24 25 26 27 28
29 30 31
Social Security No. or
Name of Business
Federal ID No.
Name of Consignee
Telephone Number
2nd SSN if joint return
Mailing Address
City or Town
State
Zip Code
Property is located in
Property Location (Number and Street or Rural Route, City) (Must List)
County
If, on January 1, you have in your possession any consigned inventory or other items not owned by you, and have not been reported on Form
62A500, complete this return. File this return on or before May 16, 2016. Attach additional schedules if necessary.
Note : Consignees who have property in more than one location must complete a separate form for each location.
Consignor Information
Consigned Inventory Information
Type
Value
Name of
Merchants Inventory
Consignor
Finished Goods
Mailing
Address
Raw Materials/Good in Process
City, State
Zip Code
Other
Name of
Merchants Inventory
Consignor
Finished Goods
Mailing
Address
Raw Materials/Good in Process
City, State
Zip Code
Other
I declare, under the penalties of perjury, that this return (including any accompanying schedules and statements) is a correct and complete return; and that all property
not owned by me but in my possession has been listed.
Signature of Consignee
Date
Email Address of Preparer Other Than Consignee
Date
Telephone Number
Email Address of Consignee
Telephone Number
Email Address of Preparer Other Than Consignee

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