Form 41 - Nebraska Railroad Tax Report - 2013
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24Nebraska Railroad Tax Report
Form 41
Due April 15
2013
Tax Year
See Instructions for Nebraska Railroad Tax Report, Form 41
Name and Location Address of Railroad
Name and Location Address of Records
Name of Railroad
Name of Records Holder (If Other Than Railroad)
Street Address
Street or Other Mailing Address
City
State
Zip Code
City
State
Zip Code
Nebraska I.D. Number
Date of Incorporation
State of Incorporation
Principal Officers in Nebraska
Name
Mailing Address, City, State, Zip Code
General Officers in Nebraska
Name
Mailing Address, City, State, Zip Code
Person to Contact Concerning This Statement
Name
Title
Mailing Address
Telephone Number
Fax Number
EMAIL address:
Person to Receive Notice of Value Indicators and Nebraska Taxable Value (if different than above)
Name
Title
Mailing Address
Telephone Number
Fax Number
EMAIL address:
Person to Receive Railroad Apportionment Reports (if different than above)
Name
Title
Mailing Address
Telephone Number
Fax Number
EMAIL address:
Person to Receive Railroad TAX STATEMENTS (if different than above)
Name
Title
Mailing Address
Telephone Number
Fax Number
EMAIL address:
Additional Information to be Filed With Form 41
For Class I Railroads:
For Non-Class I Railroads:
Surface Transportation Board (STB) Annual Report R-1
Income Statement and Balance Sheet
Securities & Exchange Commission (SEC) Federal Form 10-K
Notes to the Financial Statements
Annual Stockholder's Reports
Detail of Income and Expenses
Public Service Commission (PSC) - State Statistics
Detail of Property Accounts (Investment, Depreciation, and Net Book)
Capitalization Rate Study applicable to your company, if available
Capitalization Rate Study applicable to your company, if available
Under penalties of law, I declare that I have examined this report, including accompanying schedules and additional
reports, and to the best of my knowledge and belief, it is correct and complete.
sign
here
Authorized Signature
Title
Date
Email or Send completed report and schedules to:
Nebraska Department of Revenue, Property Assessment Division, 301 Centennial Mall South PO Box 98919, Lincoln, NE 68509-8919
Form No. 96-139-01 Form 41 cover
Form 41 NE 2013.xls Revised 01/2013
Authorized by Neb.Rev. Stat. § 77-603
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