Form At3-75 - Annual Report And Personal Property Return - 2016 Page 3

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2016
2.
Supplies (for example, office supplies) . . . . . . . . . . . . . . . . . . Average Cost $_________________________
FORM
3.
Vehicles with Interchangeable Registrations (dealer, recycler, finance company, special mobile equipment,
AT3-75
and transporter plates) and unregistered vehicles should be reported here.
Page 3
ORIGINAL COST BY YEAR OF AQUISITION
2015
2013
2012 &
Total Cost $ ____________________
2014
prior
4.
Other personal property (not included in any item above) . . . . . . . . . . . . . . . . . . . . . . .Total Cost $ ___________________
File separate schedule giving a description of property, original cost and the date of acquisition.
5.
Property owned by others and used or held by the entity as lessee or otherwise . . . . Total Cost $ ___________________
File separate schedule showing names and addresses of owners, lease number, description of property, installation date and
separate cost in each case.
6.
Property owned by the entity but used or held by others as lessee or otherwise . . . Total Cost $ ___________________
File separate schedule showing names and addresses of lessees, lease number, description of property, installation date and
original cost by year of acquisition for each location. Schedule should group leases by county where the property is located.
SECTION III
This Section must be completed if question C on page 1 is answered Yes.
A. Total Gross Revenue, or amount of business transacted during 2014 in Maryland . . . . . . . . $ _________________________
If the entity operates in Maryland and does not report any personal property, explain how the business is conducted without
personal property. If the entity is using the personal property of another business, provide the name and address of that
business.
B. If the entity operates on a fiscal year, state beginning and ending dates: ________________________________________
C. If this entity succeeds an established bank, savings bank, savings & loan or trust, provide name of former entity:
__________________________________________________________________________________________________
D. Does the entity own any fully depreciated and/or expensed personal property located in Maryland?
(Yes or No)________________ If yes, is that property reported on this return? (Yes or No)_______________________\
E. Does the submitted balance sheet or depreciation schedule reflect personal property located outside of Maryland?
(Yes or No)________________ If yes, reconcile it with this return.
F. Has the entity disposed of assets or transferred assets in or out of Maryland during 2014?
(Yes or No)________________ If yes, complete Form 4C (Disposal and Transfer Reconciliation)
PLEASE READ “IMPORTANT REMINDERS” ON PAGE 4 BEFORE SIGNING
I declare under the penalties of perjury that this return, including any accompanying schedules and statements, has been examined by
me and to the best of my knowledge and belief is a true, correct and complete return.
Print or type name of corporate office or principal of entity
Title
Name of firm, other than taxpayer preparing this return
Signature of Corporate Officer or Principal
Date
Signature of preparer
Date
Preparer’s phone number
Business phone number
Email address
Email address

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