Form 40 - Nebraska Air Carrier Annual Report
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FORM
Nebraska Air Carrier Annual Report
40
Name of Air Carrier
Reporting Period
Name of Airport
Nebraska ID Number
Street or Other Mailing Address
Federal ID Number
City
State
Zip Code
PERSON TO CONTACT WITH REGARD TO THIS FORM
Name
Title
Telephone Number
FAX Number
Email Address
SUMMARY BY TYPE OF AIRCRAFT
Number
Nebraska
Recovery
Balance Sheet
Aircraft Type
Balance Sheet
Nebraska Net Book/
Adjusted Basis for Total
Estimated Market Value
of
Period in
Accrued
and Model
Net Book Value
Aircraft Taxable Value
Aircraft
Operating Aircraft
Years
Depreciation
$
$
$
$
$
$
$
$
$
$
TOTALS
0
0
0
0
0
Under penalties of law, I declare that I have examined this report, including any accompanying schedules and statements, and to the best of my
knowledge and belief, it is correct and complete.
sign
here
Authorized Signature
Title
Date
THIS REPORT IS DUE ON OR BEFORE JUNE 1 EACH YEAR.
Mail this report to: NEBRASKA DEPT. OF REVENUE, PROPERTY ASSESSMENT DIVISION, PO BOX 98919, LINCOLN, NE 68509-8919
Authorized by Neb. Rev. Stat. §§ 77-1244 to 77-1250.05
96-134-1999 Rev. 2-2012 Supersedes 96-134-1999 Rev. 1-2010
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