Harris County Appraisal District
13013 Northwest Fwy.
P. O. Box 922007
Houston, TX 77292-2007
(713) 957-7800
Form A/P (10/10)
Affidavit
Statement of Use, Sale, Non-existence of
Property, or Discontinuance of Business
Instructions: This form is to be used to present facts or evidence concerning your property to the Harris County Appraisal District or Harris
County Appraisal Review Board. Please write legibly and attach any relevant documents. You may use this form as proof of a sale of a
business, proof of the sale or disposition of business personal property, or proof that a business did not own assets (including motor vehicles,
aircraft, and vessels) which are subject to appraisal by the Harris County Appraisal District. The completed form must be delivered to the Harris
County Appraisal Review Board before the date of any scheduled hearing. The affidavit must be executed before a Notary Public or other
official authorized to administer oaths, and submitted to the address above.
Property Owner
Tax ID Number
HCAD Account Number
Mailing Address (P. O. Box or number and street) Property Description
City, State, and ZIP + 4
Tax Year(s)
Daytime Telephone Number (area code and number)
Agent's Name and Code, if any
Part I - Owner/Business Name and Property Identification
Part II - Property Status (Mark the appropriate box and provide all relevant information in the space provided.)
Date of Closure
Date of Move
New Location
Date of Sale
Purchaser
Address
The business or property was sold.
The business was closed.
The business was moved.
Property, including vehicles, aircraft, or vessels, is not used for the production of income.
Note: Depreciable assets for purposes of federal
taxation, including motor vehicles, aircraft, vessels, as well as assets in storage are considered income producing assets.
(Please complete the chart below)
SOLD: Vehicle(s), Aircraft, or Vessel(s) sold before January 1.
Year
Built
VIN Number (vehicle),
N Number (aircraft), or
Official Number (vessel)
License Number (vehicle),
Serial Number (aircraft),
or Name (vessel)
Purchaser Name & Address Date of Transaction
Explanation: Use this space to explain or clarify the status of your business or any assets owned by your business.
Please continue on other side of form.
SITUS: Vehicle(s), Aircraft, or Vessel(s) sitused in another county or state.
(Please complete the chart below)
Year
Built
VIN Number (vehicle),
N Number (aircraft), or
Official Number (vessel)
License Number (vehicle),
Serial Number (aircraft),
or Name (vessel)
Description/Make/Model
Situs
(county or state)
(seal)
Signature of property owner/affiant
Title (Printed)
NOTARY PUBLIC, State of Texas
My Commission Expires
Part III - Attestation
The making of a false statement in a governmental record is punishable as provided by Section 37.10 of the Texas
Penal Code.
I, (printed name of person making affidavit)
, being first placed under
oath by the undersigned official authorized to administer oaths under the laws of this State, do solemnly swear or affirm that
the information herein and attached is true and correct.
Sworn and subscribed to before me this
day of
,
.