Due Date: Property Assessed January 1, 2019 Wednesday. Federal ID No. or Name of Business Organization Type Social Security No.

Transcription

1 62A5 (1-19) Commonwealth of Kentucky DEPARTMENT OF REVENUE Station T TANGIBLE PERSONAL FOR OFFICIAL USE ONLY Code Locator Number / PROPERTY TAX RETURN MAY 219 Due Date: Property Assessed January 1, 219 Wednesday May 15, 219 S M T W T F S See pages 11 and 12 for a complete Forms filed on or before due date: list of mailing addresses. CHECK APPLICABLE BOX File this return with the PVA in the county of taxable situs There is no filing extension for this return Federal ID No. or Name of Business Organization Type Social Security No. Individual 1 Name of Taxpayer(s) Telephone Number 2nd SSN if joint return Joint (Co-Owners) 2 Mailing Address NAICS Partnership / LLP 3 CODE City or Town State ZIP Code Type of Business Domestic Corp / LLC 4 Check if applicable Yes Tangible in other KY counties? Alternative Valuation? Final Return? Property is Located in District Code For Official Use Only Foreign Corp. / LLC 5 Fiduciary / Bank 6 Type Retutn Fiduciary / Other 7 NOTE: Taxpayers who have property in more than one location must complete a separate form for each location. FROM SCHEDULE A FROM SCHEDULE B Class For Official For Official Class Cost Value Use Only Cost Value Use Only 11 I 21 I 12 II 22 II 13 III 23 III 14 IV 24 IV 15 V 25 V 16 VI 26 VI 17 Total 27 Total 31 Merchants Inventory 32 Manufacturers Finished Goods See pages 3 through 5 for instructions. 33 Manufacturers Raw Materials / Goods in Process Motor Vehicles Held for Sale (dealers only) New Farm Machinery Held Under a Floor Plan New Boats and Marine Equipment Held Under a Floor Plan Salvage Titled Vehicles (insurance companies only) Recreational Vehicles Held in a Retailer's Inventory Biotechnology Products Held in a Warehouse (manufacturers and affiliates only) 34 Nonferrous Metal Located in a Commodity Warehouse and Held on Warrant 35 Goods Stored in Warehouse / Distribution Center (see instructions) 36 Goods - In Transit (see instructions) Unmanufactured Tobacco Products not at Manufacturers Plant 37 or in Hands of Grower or His nt Other Unmanufactured Agricultural Products not at Manufacturers 38 Plant or in Hands of Grower or His nt Unmanufactured Agricultural Products at Manufacturers Plant or in Hands of Grower or his nt / Industrial Revenue Bond Property 39 Qualifying Voluntary Environmental Remediation Property Taxpayer's Valuation 5 Livestock and Farm Machinery / Fluidized Bed Energy Facilities 6 Other Tangible Property (from Schedule C) (page 2) 7 Activated Foreign Trade Zone 81 Construction Work in Progress (manufacturing machinery) 82 Construction Work in Progress (other tangible property) 9 Recycling Machinery and Equipment Property Location (Number and Street or Rural Route, City)(Must List) REQUIRED For Official Use Only

2 SCHEDULE A Page Tangible Personal Property Subject to Full State and Local Rates s change every year. Please use correct year factors. CLASS I CLASS II CLASS III 5 Year Economic Life 6-8 Year Economic Life 9-11 Year Economic Life Cost Value Cost Value Cost Value Total CLASS IV CLASS V CLASS VI Year Economic Life Year Economic Life Over 18 Year Economic Life Cost Value Cost Value Cost Value Total

3 SCHEDULE B (Manufacturing Assets) 219 Tangible Personal Property Subject to Full State and Local Rates s change every year. Please use correct year factors. CLASS I CLASS II CLASS III 5 Year Economic Life 6-8 Year Economic Life 9-11 Year Econom Cost Value Cost Value Cost Total CLASS IV CLASS V CLASS VI Year Economic Life Year Economic Life Over 18 Year Econo Cost Value Cost Value Cost Total

4 Page 4 I mic Life Value I omic Life Value

5 219 MISCELLANEOUS WORKSHEET Page 5 Please check the appropriate box: Industrial Revenue Bond (IRB) Recycling Machinery & Equipment Livestock & Farm Machinery (from Line 5) s change every year. Please use correct year factors. CLASS I CLASS II CLASS III 5 Year Economic Life 6-8 Year Economic Life 9-11 Year Economic Life Cost Value Cost Value Cost Value Total CLASS IV CLASS V CLASS VI Year Economic Life Year Economic Life Over 18 Year Economic Life Cost Value Cost Value Cost Value Total

6 Page 2 SCHEDULE C Other Tangible Property Not Listed Elsewhere Materials and Supplies Research Libraries Other Tangible Property Aircraft for Hire Documented Watercraft (commercial purposes) Description Taxpayer's Value For Official Use Only Gold Platinum Silver Other Precious Metals Number Value Per Ounce of Ounces December 31 Total (enter this figure on Line Item 6 Comments Additional comments and/or information regarding alternative values may be provided by classification below: Classification Type Comments/Information I declare, under the penalties of perjury, that this return (including any accompanying schedules and statements) is a correct and complete return; and that all my taxable property has been listed. Signature of Taxpayer Date Name of Preparer Other Than Taxpayer Telephone Number of Taxpayer Address of Taxpayer Telephone Number of Preparer Address of Preparer Other Than Taxpayer Other Than Taxpayer

7 COUNTY PVA PHONE NUMBERS AND ADDRESSES Code Phone Number Address City ZIP Code 1 Adair Public Square, Courthouse Suite 2 Columbia Allen P. O. Box 397 Scottsville Anderson Ollie Bowen Court Lawrenceburg Ballard P. O. Box 267 Wickliffe Barren P. O. Box 1836 Glasgow Bath P. O. Box 688 Owingsville Bell P. O. Box 255 Pineville Boone P. O. Box 388 Burlington Bourbon Courthouse, Room 15, 31 Main Street Paris Boyd P. O. Box 434 Catlettsburg Boyle Courthouse, 321 West Main Street Room 127 Danville Bracken P. O. Box 31 Brooksville Breathitt Main Street, Courthouse, Suite 32 Jackson Breckinridge P. O. Box 516 Hardinsburg Bullitt P. O. Box 681 Shepherdsville Butler P. O. Box 538 Morgantown Caldwell E. Market Street, Courthouse, Room 28 Princeton Calloway P. O. Box 547 Murray Campbell Monmouth Street, Room 329 Newport Carlisle P. O. Box 26 Bardwell Carroll Courthouse, 44 Main Street Carrollton Carter Courthouse, Room 214, 3 W Main St. Grayson Casey P. O. Box 38 Liberty Christian P. O. Box 96 Hopkinsville Clark Courthouse, 34 South Main Street Winchester Clay Richmond Road, Suite 2 Manchester Clinton Cross Street, Courthouse, Room 217 Albany Crittenden Courthouse, 17 South Main Street. Suite 18 Marion Cumberland P. O. Box 431 Burkesville Daviess Courthouse, Room 12, 212 St. Ann Street Owensboro Edmonson P. O. Box 37 Brownsville Elliott P. O. Box 69 Sandy Hook Estill Courthouse, 13 Main Street Irvine Fayette E Vine Street, Suite 6 Lexington Fleming Court Square, Room B11 Flemingsburg Floyd South Central Avenue, Room 5 Prestonsburg Franklin W. Main St., Courthouse Annex, Room 29 Frankfort Fulton Myron Cory Drive, Suite 2 Hickman Gallatin P. O. Box 47 Warsaw Garrard Courthouse, 7 Public Sqaure, Suite 2 Lancaster Grant Courthouse, 11 North Main St., Room 15 Williamstown Graves E. South Street, Courthouse Annex, Suite 5 Mayfield Grayson 27/ Public Square Leitchfield Green South First Street Greensburg Greenup Courthouse, Room 29, 31 Main St., Box 4 Greenup Hancock P. O. Box 523 Hawesville Hardin P. O. Box 7 Elizabethtown Harlan P. O. Box 29 Harlan Harrison South Main Street, Suite 11 Cynthiana Hart P. O. Box 566 Munfordville Henderson P. O. Box 23 Henderson Henry P. O. Box 11 NewCastle Hickman E. Clay, Courthouse, Suite F Clinton Hopkins E Center St. Hopkinsville Jackson P. O. Box 249 McKee Jefferson Glassworks Building, 815 West Market St., Ste. 4 Louisville Jessamine P. O. Box 53 Nicholasville Johnson Court Street, Courthouse, Suite 229 Paintsville Kenton Court Street. Room 21 Covington 4111

8 COUNTY PVA PHONE NUMBERS AND ADDRESSES Code Phone Number Address City ZIP Code 6 Knott P. O. Box 121 Hindman Knox P. O. Box 159 Barbourville LaRue West High Street, Courthouse, Suite 1 Hodgenville Laurel Courthouse, Room 127, 11 South Main Street London Lawrence Courthouse,122 S. Main Cross Street Louisa Lee P. O. Box 18 Beattyville Leslie P. O. Box 1891 Hyden Letcher Main Street, Suite 15 Whitesburg Lewis Second Street, Suite 11 Vanceburg Lincoln East Main Street, Suite 2 Stanford Livingston P. O. Box 77 Smithland Logan P. O. Box 37 Russellville Lyon P. O. Box 148 Eddyville McCracken Courthouse Annex, 621 Washington Street Paducah McCreary P. O. Box 69 Whitley City McLean P. O. Box 246 Calhoun Madison W. Irvine Street, Suite 13 Richmond Magoffin P.O. Box 17 Salyersville Marion N. Spalding Avenue, Suite 22 Lebanon Marshall Main St. Benton Martin P. O. Box 341 Inez Mason ½ Sutton Street Maysville Meade Hillcrest Drive, Suite 3 Brandenburg Menifee P. O. Box 36 Frenchburg Mercer P. O. Box 244 Harrodsburg Metcalfe P. O. Box 939 Edmonton Monroe N. Main St., Suite A Tompkinsville Montgomery W. Main Street, Courthouse Annex, Suite E Mt. Sterling Morgan P. O. Box 57 West Liberty Muhlenberg P. O. Box 546 Greenville Nelson East Stephen Foster Avenue Bardstown Nicholas P. O. Box 2 Carlisle Ohio P. O. Box 187 Hartford Oldham W. Jefferson St. LaGrange Owen Courthouse, 1 N. Thomas St., Room 6 Owenton Owsley P. O. Box 337 Booneville Pendleton Main Street, Courthouse, Room 2 Falmouth Perry Main Street., Suite 21 Hazard Pike Main Street, Suite 33 Pikeville Powell P. O. Box 277 Stanton Pulaski P. O. Box 11 Somerset Robertson P. O. Box 216 Mt. Olivet Rockcastle P. O. Box 977 Mt. Vernon Rowan Courthouse, 6 W. Main Morehead Russell Monument Square, Ste. 16 Jamestown Scott East Main Street, Courthouse, Ste. 26 Georgetown Shelby Washington Street Shelbyville Simpson P. O. Box 424 Franklin Spencer P.O. Box 425 Taylorsville Taylor N. Court St., Courthouse, Ste. 6 Campbellsville Todd P. O. Box 593 Elkton Trigg P. O. Box 1776 Cadiz Trimble P. O. Box 131 Bedford Union P. O. Box 177 Morganfield Warren P. O. Box 1269 Bowling Green Washington Courthouse,12 E. Main Springfield Wayne N. Main St., Ste. 17 Monticello Webster P. O. Box 88 Dixon Whitley P. O. Box 462 Williamsburg Wolfe P. O. Box 155 Campton Woodford Courthouse, Room 18,13 Main Street Versailles 4383 Department of Revene Office of Property Valuation Division of State Valuation

9 COUNTY PVA PHONE NUMBERS AND ADDRESSES Code Phone Number Address City ZIP Code 51 High Street, St 32 Frankfort, KY

10 62A5-W (1-19) Commonwealth of Kentucky DEPARTMENT OF REVENUE Station T TANGIBLE PERSONAL FOR OFFICIAL USE ONLY Code Locator Number / PROPERTY TAX RETURN MAY 219 Due Date: Property Assessed January 1, 219 Wednesday May 15, 219 S M T W T F S See pages 11 and 12 for a complete Forms filed on or before due date: list of mailing addresses or address tab File this return with the PVA in the county of taxable situs CHECK APPLICABLE BOX (Documented Watercraft) Federal ID No. or Name of Business Organization Type Social Security No. Individual 1 Name of Taxpayer(s) Mailing Address Telephone Number Joint (Co-Owners) 2 NAICS Partnership / LLC 3 CODE City or Town State ZIP Code Type of Business Domestic Corp / LLC 4 Check if applicable Yes Foreign Corp. / LLC 5 Tangible personal property in other KY counties? Final Return? 2nd SSN if joint return Property Location (Number and Street or Rural Route, City)(Must List) REQUIRED Property is Located in Return cannot be transmitted electronically with income tax return. District Code For Official Use Only Fiduciary / Bank 6 Type Retutn Fiduciary / Other 7 NOTE: Owners of documented watercraft not used in the business of transporting people and/or property for compensation or hire based in Kentucky on January 1 are to complete and submit this return on or before May 15, 219, regardless of the owner's residency. File the return with the property valuation administrator in the county of taxable situs or the Office of Property Valuation. There is no extension for the filing of tangible personal property tax returns. Taxpayers who have property in more than one location must complete a separate form for each location. Documented watercraft used for hire or rented, should be reported on Schedule C or with the Public Service Section. DO NOT LIST DOMESTIC COMMERCIAL WATERCRAFT ON THIS RETURN. If your boat has been sold, please forward a copy of the bill of sale to the Office of Property Valuation. Description Line Coast Guard Vessel (Year, Make, Model, Length, Taxpayer's Statement of For Official No. Number Name Beam, Motor Horse Power) Value General Condition Use Only I declare, under the penalties of perjury, that this return (including any accompanying schedules and statements) is a correct and complete return; and that all my taxable property has been listed. Signature of Taxpayer Date Name of Preparer Other Than Taxpayer Date Telephone Number Address of Taxpayer Telephone Number Address of Preparer Other Than Taxpayer

11 62A5-A (1-19) Commonwealth of Kentucky DEPARTMENT OF REVENUE Station T TANGIBLE PERSONAL FOR OFFICIAL USE ONLY Code Locator Number / PROPERTY TAX RETURN MAY 219 Due Date: Property Assessed January 1, 219 Wednesday May 15, 219 S M T W T F S See pages 11 and 12 for a complete Forms filed on or before due date: list of mailing addresses. CHECK APPLICABLE BOX File this return with the PVA in the county of taxable situs. (Aircraft Assessments Only) Federal ID No. or Name of Business Organization Type Social Security No. Individual 1 Name of Taxpayer(s) Telephone Number Joint (Co-Owners) 2 Mailing Address NAICS Partnership / LLC 3 CODE City or Town State ZIP Code Type of Business Domestic Corp / LLC 4 Check if applicable Yes Tangible personal property in other KY counties? Final Return? 2nd SSN if joint return Property is Located in District Code For Official Use Only Foreign Corp. / LLC 5 Fiduciary / Bank 6 Type Retutn Fiduciary / Other 7 NOTE: List the serial number, federal registration number, make, model, size, power and value of aircraft owned on January 1. Attach a separate sheet if necessary. Do not list aircraft assessed as public service company property. Include additional information regarding avionic equipment, condition, engine hours and other documentation that may influence the aircraft value. All aircraft owner information submitted on the return is to be listed as it appears on the Federal Aviation Administration registration. The completed return is to be submitted to the property valuation administrator in the county of taxable situs or the Office of Property Valuation on or before May 15, 219, regardless of the owner's residency. There is no extension for the filing of tangible personal property tax returns. DO NOT LIST AIRCRAFT FOR HIRE ON THIS RETURN. Federal Property Location (Number and Street or Rural Route, City)(Must List) REQUIRED Return cannot be transmitted electronically with income tax return. Line Registration Number Description Taxpayer's Statement of For Official No. and Serial Number (Year, Make, Model, Size, Power) Value General Condition Use Only I declare, under the penalties of perjury, that this return (including any accompanying schedules and statements) is a correct and complete return: and that all my taxable property has been listed. Signature of Taxpayer Date Name of Preparer Other Than Taxpayer Date Telephone Number Address of Taxpayer Telephone Number Address of Preparer Other Than Taxpayer

12 62A5-S1 (1-19) Commonwealth of Kentucky DEPARTMENT OF REVENUE Station 32 See pages 11 and 12 for a complete list of mailing addresses or address tab AUTOMOBILE DEALER'S INVENTORY LISTING FOR LINE 34 TANGIBLE PERSONAL PROPERTY TAX RETURN Property Assessed January 1, 219 Forms filed on or before due date: File this return with the PVA in the county of taxable situs. Page No. CHECK APPLICABLE BOX Federal ID No. or Social Security No. 2nd SSN if joint return Name of Business Name of Dealer Mailing Address Telephone Number Property is located in City or Town State ZIP Code Property Location (Number and Street or Rural Route, City)(Must List) REQUIRED Year Make Model License Plate Number (If Applicable) Vehicle Identification Number NADA Trade in Value Total From This Page

13 62A5-M1 (1-19) Commonwealth of Kentucky DEPARTMENT OF REVENUE Station 32 BOAT DEALER'S USED INVENTORY LISTING FOR LINE 31 TANGIBLE PERSONAL PROPERTY TAX RETURN Property Assessed January 1, 219 Page No. See pages 11 and 12 for a complete list of mailing addresses or address tab Forms filed on or before due date: File this return with the PVA in the county of taxable situs. CHECK APPLICABLE BOX Federal Id No. or Social Security No. 2nd SSN if joint return Name of Business Name of Dealer Mailing Address Telephone Number Property is located in City or Town State ZIP Code Property Location (Number and Street or Rural Route, City)(Must List) REQUIRED Used boats held for sale by a licensed boat dealer should be reported on Line 31 of the 62A5 and listed below. Year Make Model License Number (If Applicable) Hull Number NADA Trade-in Value Total From This Page

14 62A5 - L (1-19) Commonwealth of Kentucky DEPARTMENT OF REVENUE Station 32 LESSEE TANGIBLE PERSONAL PROPERTY TAX RETURN T Code FOR OFFICIAL USE ONLY Locator Number / (For Informational Purposes Only) Due Date: MAY 219 Property Assessed January 1, 219 Wednesday May 15, 219 S M T W T F S See pages 11 and 12 for a complete Forms filed on or before due date: list of mailing addresses or address tab File this return with the PVA in the county of taxable situs CHECK APPLICABLE BOX Federal ID No. or Social Security No. Name of Business Name of Consignee Telephone Number 2nd SSN if joint return Mailing Address Property is located in City or Town State Zip Code Property Location (Number and Street or Rural Route, City)(Must List) REQUIRED Any person or business entity leasing tangible personal property from others on January 1 is required to file this return on or before May 15, 219. DO NOT complete this form if you have included the leased property on your Form 62A5. Attach additional schedules if necessary. Note: Lessees who have property in more than one location must complete a separate form for each location. Lessor Information Leased Equipment Information Name Mailing Address Type of Equipment City, State Selling Price New $ Annual Rent $ ZIP Code Date of Lease Length of Lease For Official Use Only Year Model Buy-out Price at the end of Lease $ Name Mailing Address Type of Equipment City, State Selling Price New $ Annual Rent $ ZIP Code Date of Lease Length of Lease For Official Use Only Year Model Buy-out Price at the end of Lease $ Name Mailing Address Type of Equipment City, State Selling Price New $ Annual Rent $ ZIP Code Date of Lease Length of Lease For Official Use Only Year Model Buy-out Price at the end of Lease $ I declare, under the penalties of perjury, that this return (including any accompanying schedules and statements) is a correct and complete return; and that all property not owned by me but in my possession has been listed. Signature of Lessee Date Address of Preparer Other Than Lessee Date Telephone Number Address of Lessee Telephone Number Address of Preparer Other Than Lessee

15 62A5 - C (1-19) Commonwealth of Kentucky DEPARTMENT OF REVENUE Station 32 CONSIGNEE TANGIBLE PERSONAL PROPERTY TAX RETURN T FOR OFFICIAL USE ONLY Code Locator Number / (For Informational Purposes Only) Due Date: MAY 219 Property Assessed January 1, 219 Wednesday S M T W T F S May 15, See pages 11 and 12 for a complete Forms filed on or before due date: list of mailing addresses or address tab File this return with the PVA in the county of taxable situs CHECK APPLICABLE BOX Federal ID No. or Social Security No. 2nd SSN if joint return Name of Business Name of Consignee Mailing Address Telephone Number Property is located in City or Town State Zip Code Property Location (Number and Street or Rural Route, City)(Must List) REQUIRED If, on January 1, you have in your possession any consigned inventory or other items not owned by you, and have not been reported on Form 62A5, complete this return. File this return on or before May 15, 219. Attach additional schedules if necessary. Note: Consignees who have property in more than one location must complete a separate form for each location. Consignor Information Consigned Inventory Information Type Value Name of Consignor Mailing Address City, State Zip Code Name of Consignor Mailing Address City, State Zip Code Merchants Inventory Finished Goods Raw Materials/Good in Process Other Merchants Inventory Finished Goods Raw Materials/Good in Process Other I declare, under the penalties of perjury, that this return (including any accompanying schedules and statements) is a correct and complete return; and that all property not owned by me but in my possession has been listed. Signature of Consignee Date Address of Preparer Other Than Consignee Date Telephone Number Address of Consignee Telephone Number Address of Preparer Other Than Consignee