Office of the City Assessor
900 East Broad Street, Room 802
Richmond, Virginia 23219
Industrial Property
Income and Expense Survey for Calendar Year of _____
Information provided is CONFIDENTIAL, in accordance with Virginia Law
Map Reference_______________________________ Property Address_________________________________
Form Preparer/Position________________________________________________________________________
Name Position
Telephone Number__________________ Email Address _______________________________ Date_________
The signature above declares under penalties provided by law, this return (including any accompanying schedules and statements) has been examined and is believed to
be true, correct and complete return. If the return is prepared by any person other than the owner, his / her declaration is based on all the information relating to the
matters required to be reported in the return of which he / she has knowledge.
General Data
Business Name: ______________________________________
Which of the following best describes your property? (Check one)
Single Tenant Owner-user and tenant (s)
Owner-user Multi-tenant investment
Other (describe) ________________________
Which of the following reflects the primary use of your property (Check one)
Warehouse/Distribution Mini-Warehouse
Manufacturing Multi-bay, mixed-use
Hi-Tech/Research/Development
Other (describe) _________________________
Number of buildings
One Two Three More than three
Gross Building Area (GBA): ______________square feet
Total Office Area: ______________square feet
Total Warehouse Area: ______________square feet
Total Other Area:_______ ______________square feet
Total Rentable Area
1
: ______________square feet
Parking Available: ______________# of spaces
Typical Lease Structure (Please include a copy of a typical lease)
Gross
2
Net
3
Absolute Net
4
1
Total area included in tenant lease(s).
2
Owner pays all expenses.
3
Owner pays only a few expenses; tenant (s) pays some expenses directly, such as utilities or interior maintenance.
4
Tenant pays for all expenses, including real-estate taxes and insurance.
Total Leased Area:
(Industrial Property Cont’d)
Annual Gross Income
Gross Rental Income _____________square feet $_____________/ sq.ft. = $ _______________
Other Income $_______________
Total Gross Income $_______________________________
Vacancy (Year End): ______________
___SF
Annual Operating Expenses
Real Estate Taxes $_______________________________
Insurance $_______________________________
Administrative/Legal/Accounting
$_______________________________
Repairs and Maintenance $______________
_________________
Trash/Snow Removal $_______________________________
Management Fee $___
____________________________
Utilities $_______________________________
Other:________________
___________ $_______________________________
Other:___________________________ $_______________________________
Total Operating Expenses $_______________________________
*Please identify any capital expenditures or extraordinary costs which vary from the ty
pical operating expenses?
Please include your Income Summary, rent roll or use the one enclosed as a guide and typical lease. Attach comments
and/or other information on a separate page, ie. IRS Schedule E Supplemental Income and Loss form, capital expenses,
etc…
900 East Broad Street * Richmond, VA 23219 * 804.646.7500 * Fax 804.646.5686 * www.richmondgov.com
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INDUSTRIAL PROPERTY TENANT RENT ROLL SUMMARY
Address Tenant Name Net
Rentable Area
Annual
Rent
Lease Term Tenant Expenses
Tax, Insurance Charges, etc.
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To:
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*
Extra Forms are available on our Website at: www.richmondgov.com/Assessor/forms.aspx. Please save and email this completed survey to asktheassessor@richmondgov.com.
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