Certification By Utility, Cooperative, Or Pipeline Company - Minnesota Department Of Revenue, Market Value Report - Minnesota Department Of Revenue

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Certification by Utility, Cooperative, or Pipeline Company
You must include this certification when filing a MARKET VALUE report, or we cannot process the report.
The report, as submitted, represents the system-wide utility, cooperative, or pipeline property that is owned and/or leased by the
company including that portion located within Minnesota. The information contained in this report relates to the following
company:
on January 2 of the assessment year.
Company Name
In the event that the commissioner of revenue requests information not included in this submission, the company
agrees to provide the information promptly and in the requested format.
Initial
Here
Signature of Authorized Company Representative
Title of Company Representative *
Date
Company Representative's Email Address:
I certify that I am the above named officer of said company, and that I have the authority to sign this form on behalf of the taxpayer.
I have examined the electronic file, accompanying schedules and statements. To the best of my knowledge and belief, the report is
true and complete for the year stated.
Making false statements on this report is against the law. Minnesota Statutes, section 609.41 states that anyone giving false
information in order to avoid or reduce their tax obligation is subject to a fine of up to $3,000 and/or up to one year in prison.
* The company representative must be a company President, Vice President, General Superintendent, Auditor, Tax Agent, or some other
general officer of the reporting utility or pipeline company, who is authorized by the company to file this report.

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