2021 ARIZONA BUSINESS PROPERTY STATEMENT
SHADED AREAS FOR ASSESSOR’S USE ONLY
BUSINESS NAME __________________________________________ TAXPAYER/ACCOUNT NUMBER ________________________
Taxpayer is not required to report the value of qualifying personal property that does not exceed the amount of the current year maximum exemption.
However, submitting a complete and full report of all assets is advised as it will help to ensure the correct application of the exemption and accuracy of the
assessor’s valuation. In addition, all personal property statements led with the assessor may be subject to audit, may be used as evidence in any prosecution
brought under A.R.S. § 42-15055, and may be subject to penalty if property is found to have been under-reported or to have escaped taxation. Accounts not
subject to ling requirements may be audited. A.R.S. § 42-15052 through § 42-15055 and § 42-11002.
SECTION 3: ADDITIONS AND DELETIONS: ENTER YOUR TOTAL ACQUISITION COST AND YEAR ACQUIRED OR DELETED.
ADDITIONS
Year
Acquired
New or
Used
Furniture
ofce, store or hotel
Fixtures
store, hotel or other
Machinery &
Equipment
Computers
Electronic
Equipment
phones, faxes, TV’s
Other
Please describe
DELETIONS
Year
Acquired
New or
Used
Furniture
ofce, store or hotel
Fixtures
store, hotel or other
Machinery &
Equipment
Computers
Electronic
Equipment
phones, faxes, TV’s
Other
Please describe
LEASEHOLD IMPROVEMENTS
Year
Acquired
New or
Used
Property Description
SECTION 4: ADDITIONAL INFORMATION REQUIRED.
LEASED OR RENTED PROPERTY: Attach a list of all leased or rented property in your possession.
UNOWNED PROPERTY: Attach a list of property located at your place of business which you do not own, rent or lease.
GOVERNMENT OWNED LAND: If located on government property, attach a list providing the government owner’s name and address.
By checking here, I am submitting a complete listing and requesting the assessor calculate any applicable exemption amount. I request the exemption
be applied in ____________________ County. If claiming the exemption in multiple counties, submit list with Supplemental Information
By signing below, I hereby arm that this is a full, true, and complete statement of property that is claimed by, or that is in the possession or control of the
undersigned, and it is veriable from records and les of the above named business.
_________________________________________________ _________________ __________________________________________
Print Name of Property Owner or Authorized Agent Date Email Address
_________________________________________________ _________________ If claiming exemption in multiple counties, include list
Signature of Property Owner or Authorized Agent Phone in Supplemental Information.
SUPPLEMENTAL INFORMATION ATTACHED? YES NO
TAXPAYER: RETURN ORIGINAL FORM AND COPY BOTH SIDES FOR YOUR FILES
