Cumberland County Business Property Tax Form
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Document Sample
TO AVOID LATE LIST PENALTY STATE OF NORTH CAROLINA
COMPLETE AND RETURN BY
JANUARY 31, 2012
COUNTY OF CUMBERLAND
BUSINESS PERSONAL PROPERTY LISTING 2012
RETURN TO: OFFICE OF TAX ADMINISTRATION PO BOX 449 FAYETTEVILLE NC 28302-0449
FOR DEPARTMENT BILL NUMBER TAX DISTRICT PENALTY VALUE
USE ONLY ]
_
STANDARD INDUSTRIAL CLASSIFICATION CODE (SIC#) ______________________________ LOCATION OF RECORDS _____________________________________
REAL ESTATE OWNED BY ____________________________________________________ DATE BUSINESS BEGAN IN THIS COUNTY ___________/______/_________
FED. ID#__________________________________________________________________ DATE BUSINESS (FISCAL) YEAR ENDS / /
PRINCIPAL TYPE OF BUSINESS IN THIS COUNTY __________________________________
CHECK ONE > CORPORATION___SOLE PROPRIETORSHIP___PARTNERSHIP___
ACTUAL BUSINESS LOCATION
UNINCORPORATED ASSOCIATION___OTHER(SPECIFY) ___
CHECK BUSINESS CATEGORY > RETAIL__WHOLESALE ___MANUFACTURING___
NAME SERVICE ____ LEASING/RENTAL ____ FARMING ____ OTHER(SPECIFY) ____
OTHER N.C. COUNTIES WHERE PERSONAL PROPERTY IS LOCATED
COMPANY CONTACT PERSON FOR AUDIT:
ADDRESS & PHONE:
ADDRESS
IF OUT OF BUSINESS COMPLETE THIS SECTION > DATE CLOSED___/___/___
CITY STATE ZIP PROPERTY STORED AT:
CHECK ONE: SOLD ____ STILL OWN NOW PERSONAL ________________
BUYER'S NAME:
BUYER'S ADDRESS & PHONE:
SCHEDULE A. DEPRECIABLE PERSONAL PROPERTY THIS LISTING IS SUBJECT TO VERIFICATION WITH INCOME
LIST AT 100% COST BY YEAR OF ACQUISITION INCLUDING ALL FULLY DEPRECIATED ASSETS IN YOUR POSSESSION. TAX RETURNS FILED WITH N.C. DEPT. OF REVENUE.
YEAR MACHINERY & FURNITURE & LEASEHOLD & EXPENSED SIGNS COMPUTER COPIERS TAX OFFICE USE
ACQUIRED EQUIPMENT FIXTURES IMPROVEMENTS ITEMS EQUIPMENT
1 2 3 4 5 6 7
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000 SEE INSTRUCTIONS ENCLOSED
1999
PRIOR
TOTALS
GROUP (8) FULLY DEPRECIATED ITEMS IN YOUR POSSESSION JANUARY 1:
FULLY DEPRECIATED ITEMS NOT INCLUDED IN SCHEDULE A: 100% COST
GROUP (9) CONSTRUCTION IN PROGRESS GROUP (10) SUPPLIES -- SEE INSTRUCTIONS
LIST IN DETAIL ALL EXPENDITURES FOR TYPE COST TYPE COST
PERSONAL PROPERTY IN CIP ACCOUNT ON JAN. 1, (1) OFFICE SUPPLIES (5) MEDICAL/DENTAL
BUT NOT INCLUDED ABOVE - SEE INSTRUCTIONS (2) FUELS (6) BEAUTY/BARBER
TOTAL CIP: $ (3) SPARE PARTS (7) PACKAGING MATERIALS
(4) MAINTENANCE/JANITORIAL TOTAL
SCHEDULE B. ACQUISITIONS AND/OR DISPOSALS OF MACHINERY, EQUIPMENT, FURNITURE AND FIXTURES ETC., IN THE PRIOR YEAR (ATTACH SCHEDULE IF
NECESSARY) DESCRIBE IMPROVEMENTS/ADDITIONS, NEW CONSTRUCTION SINCE LAST LISTING.
100% ORIGINAL YEAR 100% ORIGINAL
ACQUISITIONS - ITEMIZE IN DETAIL COST INSTALLED DISPOSALS - ITEMIZE IN DETAIL ACQUIRED COST
TOTAL TOTAL
LISTINGS WILL NOT BE ACCEPTED MARKED "SAME AS LAST YEAR"
Postage must be cancelled by USPS and it must be legible.
If you need additional space to list property under schedules B, C, and D, please attach a separate report
in the same format as below. Write "see attached" on the schedules if this is necessary.
SCHEDULE C. AIRCRAFT, MOBILE HOMES & OFFICES, VEHICULAR EQUIPMENT (LIST ONLY PERMANENTLY TAGGED VEHICLES AND UNLICENSED MOTOR VEHICLES).
Short Term Rental or Leased Vehicles With U-Drive It Tags Are Exempt From Property Tax. Session Law 2000-2 Gross Receipts Tax Replaces the Ad Valorem Tax Previously Levied On These Vehicles.
CAT MAKE MODEL YEAR VIN SPEC. BODY COST TITLE#/FAA# FOR OFFICE USE
STATE SPECIFIC CONDITION OF PROPERTY
SCHEDULE D. LEASED EQUIPMENT/LEASED HEAVY EQUIPMENT 1500 LBS OR MORE AND ATTACHMENTS WITH SHORT TERM LEASE OR RENTAL
IN YOUR POSSESSION ON JANUARY 1 (IF ADDITIONAL SPACE NEEDED - ATTACH SHEET) ATTACH COPIES OF ALL LEASE CONTRACTS.
NAME AND ADDRESS LEASE # OR MONTHLY COST NEW START & END
DESCRIPTION OF PROPERTY
OF OWNER ACCOUNT # PAYMENT (QUOTED) LEASE DATES
AFFIRMATION: LISTING FORM MUST BE SIGNED BY A LEGALLY AUTHORIZED PERSON TO AVOID LATE LIST PENALTY COMPLETE AND
SEE INSTRUCTIONS (AGENTS AND CPA'S ARE NOT AUTHORIZED TO SIGN FORM) RETURN BY JANUARY 31, 2012
Under penalties prescribed by law, I hereby affirm that to the best of my knowledge and belief this listing, including any accompanying statements, schedules, and other information, is
true and complete. (If this affirmation is signed by an individual other than the taxpayer, he affirms that he is familiar with the extent and true value of all the taxpayer's property subject
to taxation in this county and that his affirmation is based on all the information of which he has any knowledge.)
MUST A PRINCIPAL OFFICER FULL-TIME
Listing _______ be signed by _____________________of the taxpayer or a _______________ employee of the taxpayer who has been officially empowered by the principal
_____________________________________________________________________________________________________________
officer to list the property. FORMS WITHOUT PROPER SIGNATURE WILL BE RETURNED. (AGENTS AND CPAs ARE NOT AUTHORIZED TO SIGN FORM)
SIGNATURE (OW NER/PRINCIPAL OFFICER) DATE MUST BE ORIGINAL SIGNATURE; DO NOT FAX
PRINTED NAME PREPARER OTHER THAN TAXPAYER DATE
TITLE TELEPHONE NUMBER ADDRESS TELEPHONE NUMBER
Any individual w ho w illfully m akes and subscribes an abstract listing required by this Subchapter 105-310 (of the Revenue Law s) w hich he does not believe to be true and c orrec t
as to every m aterial m atter shall be guilty of a Class 2 m isdem eanor.
If you have questions, please contact our Custom er Service Division at (910) 678-7507 or visit our w eb site at
http://w w w .c o.c um berland.nc.us/tax.aspx
