Dor Form 82061-B - Property Tax Form - Mines (Other Than Copper) - 2014 Page 16

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BY SIGNING THE VERIFICATION PAGE, THE TAXPAYER WAIVES THE CONFIDENTIALITY REQUIREMENTS
OF A.R.S. SECTIONS 42-2001 THROUGH 42-2004 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.
MINES(OTHER THAN COPPER)
LEASED LAND SCHEDULE
Company Name___________________________________
For the Year Ended December 31, 2012
Operation______________________________________
County of___________________________
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LEASE TYPE
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DESCRIPTION &
LOCATION
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ACREAGE
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ANNUAL PAYMENT
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TERM OF LEASE
|
SECTION,TOWNSHIP,RANGE
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IN YEARS
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DOR Form 82061-B (Rev. 11-12)
PAGE A16 OF A19

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