Ca Attorney Statement from the Office of by gwz30167

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									BOE-571-RW (S1F) Rev. 3 (8-03)
                         OFFICIAL REQUIREMENT                                                                   2005                                             This statement is not a public document. The information
A report submitted on this form is required of you by                                                                                                            contain herein will be held secret by the Assessor (Code
                                                                                  RIGHT-OF-WAY PROPERTY STATEMENT                                                section 451); it can be disclosed only to the district
section 441(d) of the Revenue and Taxation Code (Code).
Failure to file it on time will compel the Assessor's Office                                                                                                     attorney, grand jury, and other agencies specified in Code
                                                                                                                                                                 section 408. Attached schedules are considered to be
to estimate the value of your property from other                                                   JAMES W. FITCH                                               part of the statement.
information in its possession and add a penalty of 10
percent as required by Code section 463.                                           KERN COUNTY ASSESSOR-RECORDER
                                                                                          1115 TRUXTUN AVENUE                                                    This statement is subject to audit.
                                                                                       BAKERSFIELD, CA 93301-4639
                                                                                     (661) 868-3485 Fax (661) 868-3209                                           Return this original form. Copies will not be accepted.


                                                                                                                                                                      Return this statement by April 1, 2005
(Make necessary corrections of the printed name and mailing address.)
                                                                                                                                                                         Contact Information
                                                                                                                                                   Name
      Mailing Address, City
      Name, DBA or C/O,

      State and Zip Code




                                                                                                                                                    Title

                                                                                                                                               Telephone

                                                                                                                                                    Fax
                                                                                                                                                  E-mail
                                                                                                                                                  (optional)




                                A                            B                                                  C                                               D                E                 F                  G
           File / Parcel Number                   Assessor's Assessed                        Designation, Name, or Number                                      Type        Width - Ft         Acquired             Basis
                                                  Value or Taxpayer's
                                                     Date Sold or
                                                                                                                                                            Status         Length - Ft        Act / Est          Act / Est
           Assessor's Use Only
                                                      Abandoned
                                                                                                                                                               Lines      Class Own            Booked             Booked
Segment
Segment
Segment
Segment
Segment




                                                                       Declaration By Assessee
                                                                                                                                                                                             Number of Continuation
                              Note: The following declaration must be completed and signed. If you do not do so, it may result in penalties.
                                                                                                                                                                                               Sheets Attached
                 I declare under penalty of perjury under the laws of the State of California that I have examined this property statement, including accompanying schedules,
                 statements, or other attachments, and to the best of my knowledge and belief, it is true, correct and complete and includes all property required to be reported
                 which is owned, claimed, possessed, controlled, or managed by the person named as the assessee in this statement at 12:01 a.m. on January 1, 2005.
                                       Signature of Assessee or Authorized Agent (see page S2F for Delcaration by Assessee instructions)                                                          Date
     Ownership Type

  Proprietorship
                                       Name of Assessee or Authorized Agent (typed or printed - see page S2F for Delcaration by Assessee instructions)                                            Title

  Parntership

                                       Name of Legal Entity (other than DBA - typed or printed)                                                                                   Federal Employer Identification Number
  Corporation


  Other (describe)
                                       Prepare's (typed or printed)                                                                                              Title                                 Telephone Number
                                        Name
                                        Address
BOE-571-RW (S1F) Rev. 3 (8-03)
2005 RIGHT-OF-WAY PROPERTY STATEMENT

                   A                     B                          C                   D          E            F           G
          File / Parcel Number   Assessor's Assessed   Designation, Name, or Number   Type     Width - Ft    Acquired     Basis
                                 Value or Taxpayer's
                                    Date Sold or
                                                                                      Status   Length - Ft   Act / Est   Act / Est
          Assessor's Use Only
                                     Abandoned
                                                                                      Lines    Class Own     Booked      Booked
Segment
Segment
Segment
Segment
Segment
Segment
Segment
Segment
Segment
Segment
Segment
Segment
Segment




                                                                                                        Contuation Sheet Number

								
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