Form Boe-517-Eg - Property Statement - Electric Generation Companies

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BOE-517-EG (S1F) REV. 10 (12-12)

STATE OF CALIFORNIA

PROPERTY STATEMENT—ELECTRIC GENERATION COMPANIES

BOARD OF EQUALIZATION

2013

DECLARATION OF COSTS AND OTHER RELATED PROPERTY INFORMATION

AS OF 12:01 A.M., JANUARY 1, 2013

This statement must be completed, signed, and filed with the State-Assessed Properties Division, Board of Equalization,

P.O. Box 942879, Sacramento, California 94279-0061, by March 1, 2013. Omit cents; round to the nearest dollar.

OFFICIAL REQUEST

NAME, STREET, CITY, STATE and ZIP CODE

This request is made in accordance with section 826 of the

Revenue and Taxation Code. This property statement must be

completed according to the instructions and filed with the Board

of Equalization (BOE) on or before March 1, 2013. If you do not

file this statement, it may subject you to the penalty provided

in section 830 of the Revenue and Taxation Code. Attached

schedules are considered to be part of the statement. THIS

STATEMENT IS SUBJECT TO AUDIT.

SBE No.

MAKE NECESSARY CORRECTIONS TO ADDRESS LABEL

Indicate if above is a change of name and/or address.

DATE

DATE TO BE

NAME AND ADDRESS OF PERSON TO WHOM CORRESPONDENCE

THIS STATEMENT SHALL CONSIST OF:

N/A

SUBMITTED

REGARDING AUDIT SHOULD BE ADDRESSED:

NAME

(1) Financial Schedules A to H

(2) Tangible Property List

MAILING ADDRESS (including zip code)

(3) Statement of Land Changes

(4) Schedule of Intangible Information

TELEPHONE NUMBER

(5) Schedules of Leased Equipment

BOE-600-A

(

)

BOE-600-B

EMAIL ADDRESS

(6) Other Information

LOCATION OF ACCOUNTING RECORDS (street, city, state, and zip code)

(see instructions on reverse)

a. Annual Report to State Agencies

b. Annual Report to–Owners

c. Comparative Balance Sheets

NAME OF AUTHORIZED REPRESENTATIVE (if applicable)

d. Power Purchase Agreements

e. Engineering, Procurement, and

ADDRESS (street, city, state, and zip code)

Construction Contracts

f. Plant Management and/or Operation &

Maintenance Contracts

DAYTIME TELEPHONE NUMBER

(

)

g. A copy of all RMR and RA contracts

EMAIL ADDRESS

h. A copy of operating budget

i. Other information as requested

* BOE-892, Statement of Authorization, must be filed annually.

List business activities: _____________________________________________________________________________________________________

(4) ENTITY TYPE:

Proprietorship

Partnership

Corporation

Other

Change in ownership prior 12 months?

Yes

CERTIFICATION

I certify (or declare) under penalty of perjury under the laws of the State of California that I have examined this Property Statement, including accompanying

schedules and statements, and to the best of my knowledge and belief it is true, correct, and complete and covers all property required to be reported which is

owned, claimed, possessed, controlled, or managed by the person named in the statement at 12:01 a.m. on January 1, 2013. If prepared by a person other than

the taxpayer, this declaration is based on all information of which preparer has knowledge.

FULL LEGAL NAME IF INCORPORATED

FOR OFFICIAL USE ONLY

SIGNATURE OF OWNER, PARTNER, OFFICER, OR AUTHORIZED AGENT

DATE

2013

NAME OF SIGNATORY (please print)

TITLE

SIGNATURE AND ADDRESS OF PREPARER OTHER THAN TAXPAYER

DATE

2013

INFORMATION PROVIDED ON A PROPERTY STATEMENT MAY BE SHARED WITH OTHER STATE BOARD OF EQUALIZATION DEPARTMENTS