Fillable Block # Lot # Estimated age of Property (Middlesex County Government)

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Block # Lot # Estimated age of Property (Middlesex County Government)

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U.S.A. forms for Middlesex County Government

BROWSE MIDDLESEX COUNTY GOVERNMENT (NJ) FORMS

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Block # Lot #
Address
Estimated age of Property years
years
@ $ Management % $
@ $ Fuel $
@ $ Electricity & Gas
@ $ $
@ $ Water_____________________ $
@ $ Superintendent-Apartment_____ $
@ $ Salary________ $
@ $ Other Wages_______________ $
@ $ $
@ $ Painting & Decorating ________ $
@ $ Repairs & Maintenance_______ $
Other Income @ $ (Explain below)
Total Gross Income per month $ Reserve for Replacement $
(Itemize on table)
$ Miscellaneous ______________ $
TOTAL OPERATING EXPENSE $
$
FIXED CHARGES
Insurance (Annual Basis)______ $
Taxes_____________________ $
Owner's share $____________ $
Item Annual Reserve
Tenants' share $____________
$ Mortgage (Interest)__________ $
$ (Principal)_________ $
$ Depreciation_______________% $
$ Other (Explained below)_______ $
$ TOTAL FIXED CHARGES_____ $
$ TOTAL EXPENSE___________ $
$ REMARKS
$
$
$ Amount of Mortgage
$ Date of Mortgage
$ Terms of Mortgage
(year)
at________________________________
Taxing District
USE ADDITIONAL SHEETS IF NECESSARY
Estimated remaining economic life
of property
Name of Owner
Address
City
OPERATING EXPENSE
PHOTOSTATIC COPIES OF LEASES MUST BE SUBMITTED WITH THIS PETITION. IF NOT, PERTINENT CONDITIONS OF THE
LEASE / LEASES WILL BE ACCEPTED. ATTACH THIS STATEMENT TO PETITION OF APPEAL FORM AND COPY TO TAXING
DISTRICT.
I hereby certify that the information furnished hereon, or attached hereto is correct and full statement of the above
captioned property, to the best of my knowledge and belief.
(Owner, Agent, Officer, Accountant, Etc.)
(Notary Public)
(City or Town)
MIDDLESEX COUNTY BOARD OF TAXATION
STATEMENT OF INCOME AND EXPENSE
To be reported for your fiscal year ending October 1, 20 __
Itemize income for reach individual apartment, store, or
rentable space of any kind, the gross annual rent from leases
entered into and assigning reasonable rent to unoccupied and
non-rented spaces and so indicate:
EXPENSES
INCOME
Est. Life
Public Area & Oil Burner______
FICA and other Employee Taxes
Reserve for Replacement
Total Reserve for Replacement
Subscribed and sworn before me this ___________ day of
______________________________________
Actual rent loss by reason of
vacancies for past 12 months
last fiscal year
$
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Block Lot Estimated age of Property (Middlesex County Government)

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Completed 18 July 2020

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