Dor Form 82059 - Property Tax Form - Private Car Companies - 2014 Page 3
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6CONFIDENTIAL
PRIVATE CAR COMPANIES
CORPORATE INFORMATION
CORPORATE INFORMATION – Continued
8.
Did your private car(s) travel within or through Arizona during calendar year 2012?
Yes
No
If you answered "NO" to question #8 above, you do not need to complete the remainder of this report.
Complete the certification below and return the report by April 1, 2013.
CERTIFICATION
I hereby certify that, to the best of my knowledge and belief, private car(s) owned and/or operated by this
company DID NOT travel within or through Arizona during the year ending December 31, 2012.
Dated this
day of
, 20____.
Signature
Title
If you answered "YES" to question #8 above, complete the remainder of this report.
DOR Form 82059 (Rev. 12/12)
Page 3 of 6
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