Form 150-504-004 - Confidential Personal Property Return 2001
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1
22001
2001
CONFIDENTIAL PERSONAL PROPERTY RETURN
(ORS 308.290)
If you have no personal property, fill in section “No Personal Prop-
Filing Deadline: March 1, 2001
erty To Report,” sign Taxpayer’s Declaration and file this return.
PENALTY—
Maximum penalty for late filing of personal property return is 100 percent
of the tax attributable to the taxable personal property. (ORS 308.296)
Account Number
Code Area
FOR ASSESSOR’S USE ONLY
1. Leased or Rented Property
2. Noninventory Supplies
3. Floating Property
4. Libraries
5. All Other Property
6.
7. Total Real Market Value
8. Late Filing Penalty
Make any name or mailing address corrections above. Date changed _______________
TAXPAYER’S DECLARATION
This Return is Subject to Audit
Invalid if not signed. Under the penalties of false swearing in ORS
LOCATION OF PERSONAL PROPERTY ON JANUARY 1, 2001.
305.990(4), I declare that I have examined this return and all attachments.
File a separate return for each tax code area (or location). Attach a separate listing if needed.
All statements made are true. To the best of my knowledge, all taxable
Personal Property Location (street address, city)
personal property I own, possess, or control, which was in this county as of
1:00
.
., January 1 has been reported.
A
M
Date business originated in county
Type of Business
Name of Firm/Owner
Assumed Business Name of Firm Assessed
Phone No.
Was a return filed last year?
YES
County ________________
NO
(
)
First Time Filer
(See General Information, No. 1)*
Mailing Address
FAX No.
(
)
City
State
ZIP Code
2000 Assessment Cancelled by the Assessor
(See General Information, No. 2)*
Signature of Person Responsible for Return
Date
* Remember to sign the Taxpayer’s Declaration at right.
X
Printed Name of Person Signing Return
Title
No Personal Property to Report
(See General Information, No. 3)*
If so, date closed:
Business closed?
THIS RETURN BEING FILED FOR:
Business sold? Enter date of sale.
Name of New Owner
An Individual
A Partnership (No. of persons ____ )
A Corporation
A Limited Partnership
Address of New Owner
A Limited Liability Company
Limited Liability Partnership
Attach a separate list of names and addresses of each individual partner.
Submit your original return and attachments to your county assessor. Keep a photocopy and the attached instructions for your records.
SCHEDULE 1 — LEASED OR RENTED PERSONAL PROPERTY
(Do not report real property. Enter “None” if no personal property to report)
Payer of
11
1
2
3
AMOUNT OF
6
7
8
9
10
Owner’s Opinion of
Name and Address of
Original Cost
Assessor’s
Date
Length
Taxes to County
Second Party Involved
Description
LEASE / RENT
Agree-
of
Market Value
RMV
No. of
2nd
ment
Agree-
In Lease/Rent Agreement
(Include model year)
4
5
(Leave blank)
Each
Total
Filer
Mo.
Yrly.
Units
TOTAL
Party
Began
ment
If Schedule 1 items are reported on separate attachments, check here:
Schedule 1 TOTAL:
(Include attachments)
SCHEDULE 2 — NONINVENTORY SUPPLIES
(See instructions for examples)
6
7
REPORT TOTAL COST ON HAND AS OF JANUARY 1
Owner’s
Assessor’s
Opinion of
RMV
1
2
3
4
5
Other Noninventory
General Office Supplies
Maintenance Supplies
Operating Supplies
Spare Parts
Market Value
(Leave Blank)
Supplies
If Schedule 2 items are reported on separate attachments, check here:
Schedule 2 TOTAL:
(Include attachments)
1
150-553-004 (Rev. 10-00) Web
RETURNS MARKED “SAME AS LAST YEAR” MAY NOT BE ACCEPTED
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