Office of the City Assessor
900 East Broad Street, Room 802
Richmond, Virginia 23219
Office 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 preparer 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 Description Information
(Please check applicable category and complete the related questions.)
Occupancy
Property is 100% owner-occupied Total Building Area ______________ Sq.Ft.
Property is occupied by owner/tenant Owner-occupied Area ______________ Sq.Ft.
Tenant-occupied Area ______________ Sq.Ft.
______________________________________________________________________________________________________________________________________
Basement/Storage
Y N
Is there a basement _______ Sq.Ft.
Is the basement finished Sq.Ft.
Is the basement leased separate Leased amount $________
Is there storage area ______ Sq.Ft
_____________________________________________________________________________________________________________________________________
Status if currently not occupied
Property is: Vacant Available for Sale Asking Price $ ____________
Available for Rent Asking Rent $____________
_______________________________________________________________________________________________________________________________________
Parking
Number of Total Spaces________ Rent received per/month for leased parking $________
_______________________________________________________________________________________________________________________________________
Other Leased space: Cell Tower Date of Lease _______ Lease Amount $________ per/year
Company Name:__________________________________
Annual Income
Base Rental Income – Minimum $_________________
Additional Rental Income – overages $_________________
Parking Rental Income $_________________
Total Rent $_________________
Other Income (Reimbursements from Tenants)
Common Area Charges $_________________
Property Tax Reimbursement $_________________
Insurance Reimbursement $_________________
Utility Charge Reimbursement $_________________
Total Operating Receipts $__________________
Total Annual Income $__________________
Vacancy & Collection Loss ________________SF
(Year End)
Annual Operating Expenses
CAM* Paid By Paid By
Expense Landlord Tenants
Fixed Expenses
Real Estate Taxes $_______________
Insurance $_______________
Variable Expenses
Repair & Maintenance $_______________
Parking Lot Maintenance $_______________
Parking Rental Expense $_______________
Utilities $_______________
Trash Removal $_______________
Security $_______________
Advertising/Promotional $_______________
Administrative Expenses $_______________
Professional Services $_______________
Management Fees $_______________
Leasing Agent Fees $_______________
Other:_________________ $_______________
Other:_________________ $____________ ___
Total Operating Expenses $___________________
Net Operating Income $___________________
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…
0
0
0
0
OFFICE TENANT RENT ROLL SUMMARY
Address Tenant Name Net
Rentable Area
Annual
Rent
Lease Term Tenant Expenses
Tax, Insurance Charges, etc.
From:
To:
From :
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
*
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
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome