Form Rpie-2016 - Real Property Income And Expense Worksheet And Instructions For Self-Storage Facilities Page 14
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16RPIE-2016-A - Real Property Income & Expense Form - Self-Storage Facilities Only
Page 2
sECtIoN E - VACANCY INFoRMAtIoN
1
Percentage of Space that was vacant as of the taxable status date (January 5, 2017): ________________ %
sECtIoN h - LEAsE AND oCCUPANCY INFoRMAtIoN
1.
Does the tenant lease the entire property?
❑ Yes
❑ No
2.
Does the tenant pay utility expenses?
❑ Yes
❑ No
3.
Does the tenant pay maintenance and repair expenses?
❑ Yes
❑ No
4.
Does the tenant pay property tax for the space occupied?
❑ Yes
❑ No
5.
What is the Annual Rent paid to the Property Owner?
______________
6.
Is the net lessee or owner related party subleasing any of the property?
if YEs, then please provide responses to questions 6a-c.
a)
What is the Square Footage?
______________
b)
What is the Use of Space?
______________
c)
What is the Annual Rent?
______________
7.
Are you filing as ground lessor?
if YEs, then please respond to question 7a
a)
What is the Ground Lease Amount that you are receiving?
______________
sECtIoN I - REPoRtINg PERIoD
1.
The 2016 income and expense statement is for a:
The 2015 income and expense statement is for a:
The 2014 income and expense statement is for a:
❑
❑
❑
❑
❑
❑
❑
❑
❑
Calendar Year
Fiscal Year
Partial Year
Calendar Year
Fiscal Year
Partial Year
Calendar Year
Fiscal Year
Partial Year
2. Indicate the period covered in this statement:
Indicate the period covered in this statement:
Indicate the period covered in this state-
ment:
Month
Year
Month
Year
Month
Year
Month
Year
Month
Year
Month
Year
From ________/ 2016
To ________/ 2016
From ________/ 2015
To ________ / 2015
From ________/ 2014
To ________/ 2014
3. Name of the Facility:__________________________________________________________________________________________
sECtIoN k - INCoME & FEEs. Do not list any negative figures.
2016
2015
2014
Income ($ per year)
Income ($ per year)
Income ($ per year)
(Round to nearest $)
(Round to nearest $)
(Round to nearest $)
self-storage Real Estate Rental Income
1. Rent
self-storage Unit Rental Business Income
1. Self-Storage Unit Rentals
total Rent
other Business Income
1. Merchandise
2. Truck Rentals
3. Outdoor Vehicle Storage
4. Other Sales
5. total Business Income
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