COPPER MINES
CONFIDENTIAL
LOCATION BY TAX AREA CODE OF
ORIGINAL COST FOR REAL AND PERSONAL PROPERTY
Based on Original Cost
Company Name:_____________________________
County of __________________________
(Figures Expressed in Thousands of Dollars)
Operation: __________________________
For the Year Ended December 31, 2012
----------- --------------- ---------------- ---------------- ---------------- ---------------- ----------------
1.
PERSONAL PROPERTY
----------- --------------- ---------------- ---------------- ---------------- ---------------- ----------------
|TAX | MINING
| SMELTER | ENVIRON-| OFFICE| REFINING| LEACHING| CONSTRUC| MISCELLA|SEC. 41-|ORIGINAL
|CODE|
|
|
MENTAL |
| &MILLING| & SXEW
|
-TION
|
-NEOUS |1514.02 |COST SUM
----------- --------------- ---------------- ---------------- ---------------- ---------------- ----------------
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|SUM_|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
_____________________________________________________________________________________________________________
2.
BUILDINGS AND STRUCTURES
----------- --------------- ---------------- ---------------- ---------------- ---------------- ----------------
|TAX | MINING
| SMELTER | ENVIRON-| OFFICE| REFINING| LEACHING| CONSTRUC| MISCELLA|SEC. 41-|ORIGINAL
|CODE|
|
|
MENTAL |
| &MILLING| & SXEW
|
-TION
|
-NEOUS |1514.02 |COST SUM
----------- --------------- ---------------- ---------------- ---------------- ---------------- ----------------
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|____|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
|SUM_|_________|_________|_________|_______|_________|_________|_________|_________|________|________________
DOR Form 82061-A (Rev. 11-12)
PAGE A18 OF A25