Dor Form 82061-C - Property Tax Form - Small Scale Mines - 2014 Page 10

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BY SIGNING THE VERIFICATION PAGE, THE TAXPAYER WAIVES THE CONFIDENTIALITY REQUIREMENTS OF A.R.S.
SECTION 42-2001 THROUGH 42-2OO4 WITH RESPECT TO THIS PAGE AND CONSENTS TO THE DISCLOSURE OF THE
CONTENTS OF THIS PAGE TO COUNTY ASSESSOR PERSONNEL BY THE DEPARTMENT OF REVENUE.
SMALL SCALE MINES
Company Name_______________________________
For the Year Ended December 31, 2012
NON-OPERATING LAND, IMPROVEMENTS AND PERSONAL PROPERTY
Operation __________________
County of __________________________
-----------------------------------------------------------------------------------------------
COUNTY
| TAX AREA | ASSESSOR PARCEL NUMBER |
DESCRIPTION OF
|
FULL CASH VALUE
|
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CODE
|
BOOK |
MAP | PARCEL |
PROPERTY
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DOR Form 82061-C (Rev. 11-12)
PAGE A10 OF A12

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