Personal Property Listing Form 2011 - Henderson County Tax Department
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2HENDERSON COUNTY, NORTH CAROLINA
Henderson County Tax Department
PERSONAL PROPERTY LISTING FORM
Personal Property Listing
200 North Grove Street Suite 102
TAX YEAR 2011
Hendersonville, NC 28792-5027
For information regarding this form, please call (828) 697-4870
Or visit our website at
January 01, 2011
ATTENTION MANUFACTURED HOME OWNERS:
If you sold
«Name1»
a manufactured home during calendar year 2010, please indicate the
«Name2»
new owner below.
Name ______________________________Phone__________
«Addr1»
«Addr2»
Address ___________________________________________
«City» «St» «Zip»
City, St, Zip ________________________________________
ABSTRACT #: «Abstract»
Date Sold ___________________Sale Price_______________
IMPORTANT: Please read form carefully and follow all instructions.
Indicated below is personal property we have listed in your name and will bill you for in 2011.
Please make any necessary corrections:
«Desc1»
«Desc4»
«Desc2»
«Desc5»
«Desc3»
«Desc6»
**Draw one line through any property you did not own on January 1, 2011**
Please list any untagged vehicles, motorcycles, trailers, recreational vehicles, boats, personal
watercraft, aircraft or manufactured homes in your possession as of January 1, 2011 that are not
listed above.
**Do not list licensed (tagged) vehicles, leased vehicles, or real property.**
Property
Year
Make
Model
Vehicle Identification
Length
Width
Actual Address Where Located
Type
New
Number
You must return the completed form by January 31, 2011, to avoid a 10% late listing penalty.
For information regarding tax relief for the elderly or disabled, see back of this form.
Under penalties prescribed by law, I hereby affirm that to the best of my knowledge and belief this listing including any accompanying
statements, inventories, 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 of the information of which he has any knowledge.) Any individual who willfully makes and subscribes an
abstract listing required by this Subchapter which he does not believe to be true and correct as to every material matter shall be guilty of a
Class 2 misdemeanor.
________________________
____________________
________________________
Signature
Date
Employer
________________________
____________________
________________________
Social Security Number
Home Phone
Business Phone
SOCIAL SECURITY NUMBER:
The authority to require this number for the administration of a tax is given by U.S. Code Title 42,
Section 405(c)(2)(c) (i) and NCGS 105-309. The number will be used to facilitate collection of property taxes if you do not timely and
voluntarily pay the taxes, and will allow the tax collector to claim payment of an unpaid property tax bill from any State income tax refund
that might otherwise be owed to you. Your social security number may be shared with the State for this purpose. In addition, your social
security number may be used to attach wages or garnish bank accounts for failure to timely pay taxes. In accordance with the Identity
Theft Protection Act of 2005, we will not use the number for any other purpose than what is stated above. We will redact the number in
case of a public records request, and we will not print the number on any other document, unless required by law.
NOTICE:
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