Form 901 - Personal Property Pro

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State of Oklahoma
BUSINESS PERSONAL PROPERTY RENDITION
OTC
901
Tax Year
2015
Tulsa County
(918) 596-5100
Fax (918) 596-4799
Return to County Assessor - Filing Date: January 1 - Delinquent Penalties after March 15
Revised 6-2014
Ken Yazel, Tulsa County Assessor, 500 S. Denver Ave., Suite 215, Tulsa, OK 74103
RE#
75253-55-55-12345
PP#
P00000596001234
REPORT ONLY TANGIBLE ASSETS
T-9A
Owner/DBA
Part One: Start Here
*P00000596001234*
Doug Anderson
Sample Oklahoma 901
Mailing Address
9719 S 92 E Ave
Tulsa, OK 74133
Phone Number
Email Address
(918) 252-1157
oklahoma@oklahoma.com
73-1112222
Type of Business
Software Programming
North American Industry
Classification System
7
2
3
Are other businesses included in this rendition?
If yes, please list:
8
3
2
X
Yes
No
Other businesses listed here ...
Physical location if different than mailing address
94132 South 92nd East Avenue, Tulsa OK 55555-5555
Please provide the name and number of person to contact for audit purposes:
Sue Jones
X
Are you renting or leasing this business location?
Yes
X
Date:
Yes
(918) 252-1157
X
No
Are you still in business at this location?
No
If no, do you still own the business personal property?
Business was renamed from 'Old business name'
to 'Sample Oklahoma 901' on 6/5/2012
If yes, do you own any real estate improvements at this location?
When did you start business at this location?
FEIN
07/01/1995
Date Disposed/Sold:
Yes
No
Yes
No
If disposed or sold, stop here.
Sign and return.
PART TWO: OKLAHOMA TAXABLE FIXED ASSETS, FROM FORM 904 SCHEDULE 3 OR 3A
DESCRIPTION
Beginning Total
Original Cost or RCN
Not Book Value
Leasehold Improvement
Deletions to Total
Original Cost or RCN
Not Book Value
Ending Total
Original Cost or RCN
Not Book Value
500
400
10,750
950
2,995
2,245
5,240
19,800
2,105
21,905
500
3,300
3,800
8,300
600
8,900
Original Cost
1,950
4,560
Other Assets and Trade Tools
Original Cost
1,200
800
2,000
1,200
1,200
Original Cost
Furniture and Fixtures
Original Cost
Electronic Equipment
Original Cost
Computer Equipment
Original Cost
Machinery Equipment
Original Cost
Forklifts and Construction
Original Cost
Tooling, Dies and Molds
*
*
*
Additions to Total
Original Cost or RCN
Not Book Value
Leased to Others
Original Cost
Assessor Use
Reconciled
Assessed Value
900
500
11,200
700
5,810
Leased from Others
Original Cost (See Instructions)
>
See Instructions
>
Total Fixed Assets
$
60,955
PART THREE: OKLAHOMA TAXABLE INVENTORY
Inventories
Total supplies, parts,
equipment, etc. stored
and/or not currently in use
including raw materials,
work in progress, finished
goods, etc.
16,372
+
Consignment and/or Floorplan Inventory
Net Taxable Inventory =
$
01/10/2015
Date
01/10/2015
Signature of taxpayer
TWForms - OK901P1 2014-09
Date
Total Assessed
4,815
Penalty
1,200
Total Net
12,757
State of Oklahoma - County of _Tulsa_
I, _Henry James III_ under penalties of perjury, do hereby depose and say that I am _President_ of _Sample Oklahoma 901_
company; that as such I am acquainted with the books, accounts, and affairs of said company and know that the
accompanying statement to be true, correct, and complete, and that all information requested herein has been fully and
correctly given. (68 O.S. Section 2945 provides penalties for false oaths)
Don't Forget
to Sign
Total
Net Inventory
Average Inventory (From Part 6)
Less Freeport Exemption (Form 901-F)
Signature of preparer if other than taxpayer
Total
Date Filed
______/______/________
School District
Assessment %
123 CPA Avenue - Accountant City, OK 55555
Preparer's address
1234567
Preparer's identification number
(John Doe Company)
(918) 555-1212 Ext 1234
Preparer's phone number
FORM 901 PAGE 2
Name of Business ...........:
Address ...........................:
Personal Property Acct # :
TAX YEAR
2015
Sample Oklahoma 901 (Doug Anderson)
9719 S 92 E Ave - Tulsa, OK 74133
P00000596001234
PART FOUR: ADDITIONS DURING THE REPORTING YEAR
Item
Number
Leasehold Improvement
Year Acquired
New
Used
Total Original Cost or RCN
34
Repaired sign
2014
225
39
Curb put in
2014
175
$400
Total LI Additions acquired in 2014 ->
Total Additions for Leasehold Improvement
Item
Number
Furniture and Fixtures
Year Acquired
New
Used
$400
Total Original Cost or RCN
19
Receptionist desk
2014
350
29
Couch
2014
100
37
Misc furniture
500
2014
$950
Total F&F Additions acquired in 2014 ->
Total Additions for Furniture and Fixtures
Item
Number
Electronic Equipment
16
Blueprinting machine
35
Copier
Year Acquired
New
Used
Total Original Cost or RCN
2,100
2014
145
2014
$2,245
Total EE Additions acquired in 2014 ->
Total Additions for Electronic Equipment
Item
Number
15
21
Computer Equipment
Printer table
Dell Dimension 8200
Year Acquired
New
Used
2014
55
2014
2,050
$2,105
Total Additions for Computer Equipment
17
Machinery and Equipment
Year Acquired
New
Standard lathe
Used
10
Forklifts and Construction
3,300
2014
Year Acquired
New
Tires for forklift
Used
Tooling, Dies, and Molds
600
2014
18
Various molds for proto-typing
26
Power drill
Year Acquired
New
Used
4,400
2014
160
2014
$4,560
Total Additions for Tooling, Dies, and Molds
9
Other Assets and Trade Tools
Misc tools, wrenches, screwdrivers etc
Year Acquired
New
Used
$4,560
Total Original Cost or RCN
800
2014
Total Additions for Other Assets and Trade Tools
TWForms - OK901P2 Rev 2011-11
$600
Total Original Cost or RCN
Total TDM Additions acquired in 2014 ->
Item
Number
$3,300
Total Original Cost or RCN
Total Additions for Forklifts and Construction
Item
Number
$2,105
Total Original Cost or RCN
Total Additions for Machinery and Equipment
Item
Number
$2,245
Total Original Cost or RCN
Total CE Additions acquired in 2014 ->
Item
Number
$950
$800
Page 1 of 2 of Form 901 Page 2
FORM 901 PAGE 2
Name of Business ...........:
Address ...........................:
Personal Property Acct # :
2015
TAX YEAR
Sample Oklahoma 901 (Doug Anderson)
9719 S 92 E Ave - Tulsa, OK 74133
P00000596001234
PART FOUR: ADDITIONS DURING THE REPORTING YEAR
Item
Number
Year Acquired
Leased To Others
7
New
Leased old chairs to Dairy Queen
Total Original Cost or RCN
900
2014
Lease Information
Asset Type : Furniture
Lessee Name : Lesse Name here
Address : lessee's address
Phone : lessee's phone
20
Used
Age of Asset : 1 years
Lease Term : 36 months
Leased mapping machine to Ralph
Payment : $500
300
2014
Lease Information
Asset Type : Map type asset. Not sure
Lessee Name : Ralph Smith
Address : 333 Smith lane
Phone : (918) 232-3232
Age of Asset : 8 years
Lease Term : 2 years
Payment : $75
$1,200
Total LTO Additions acquired in 2014 ->
$1,200
Total Additions for Leased To Others
Item
Number
Year Acquired
Leased From Others
5
New
Dell Dimension Computer
Used
Total Original Cost or RCN
2010
Lease Information
Asset Type : Bob's asset type
Age of Asset : 5 years
Lease Term : monthly
First Year of Lease : 2010
Owner Name : Bob Henderson
Address : 123 Bobby Street
Phone : (918) 252-1234
Payment : $250
Total Additions for Leased From Others
Total Additions for Tax Year 2015 >
$16,160
PART FIVE: DELETIONS DURING THE REPORTING YEAR
Item
Number
Furniture and Fixtures
11
Fat Freddy's Furniture
Year Acquired
New
Used
Total Original Cost or RCN
500
2007
$500
Total Deletions for Furniture and Fixtures
Item
Number
Year Acquired
Tooling, Dies, and Molds
6
New
Mold #4823
Used
Total Original Cost or RCN
700
2013
Total Deletions for Tooling, Dies, and Molds
Total Deletions for Tax Year 2015 >
$700
$1,200
For Additions & Deletions, subtotals are printed within each category if there is more than one asset listed for the same year.
PART SIX: MONTHLY INVENTORY
January
February
6,333
July
78,000
TWForms - OK901P2 Rev 2011-11
March
April
2,000
August
May
June
November
December
Average
400
September
October
9,000
2,500
16,372
Page 2 of 2 of Form 901 Page 2
OTC
904-A
State of Oklahoma
ASSET LISTING (GROUPED)
Tax Year
Taxpayers filing in TULSA County: Must complete this schedule listing like or similar items
grouped by description, year of acquisition and original cost and class. This schedule to be
filed with completed OTC Form 901 rendition.
Schedule 3-A
Revised 6-2014
Name of Business:
Sample Oklahoma 901 (Doug Anderson)
Address ...............:
9719 S 92 E Ave - Tulsa, OK 74133
Personal Property Account Number:
Phone:
P00000596001234
Email Address:
REPORT ONLY TANGIBLE ASSETS
Item
Number
Leasehold Improvement
(918) 252-1157
oklahoma@oklahoma.com
ASSESSORS USE ONLY
Year Acquired
1
2015
New
34
Repaired sign
2014
39
Curb put in
2014
Used
Original
Cost
LIFE
YEARS
%
GOOD
FACTOR
RCLND
225
175
$400 < Total LI acquired in 2014
1
New sign
2013
500
$500 < Total LI acquired in 2013
Leasehold Improvement Total
Item
Number
Furniture and Fixtures
Year Acquired
2
New
19
Receptionist desk
2014
29
Couch
2014
37
Misc furniture
Used
$900
Original
Cost
Ttl
LIFE
YEARS
%
GOOD
FACTOR
RCLND
350
100
2014
500
$950 < Total F&F acquired in 2014
12
Old Mahogony desk
2013
10,000
$10,000 < Total F&F acquired in 2013
28
Lamps
2012
250
$250 < Total F&F acquired in 2012
Furniture and Fixtures Total
Item
Number
Electronic Equipment
Year Acquired
3
New
16
Blueprinting machine
2014
35
Copier
2014
Used
$11,200
Original
Cost
Ttl
LIFE
YEARS
%
GOOD
FACTOR
RCLND
2,100
145
$2,245 < Total EE acquired in 2014
40
CAD Drafting table
2012
2,995
$2,995 < Total EE acquired in 2012
Electronic Equipment Total
Item
Number
Computer Equipment
Year Acquired
4
New
Used
$5,240
Original
Cost
Ttl
LIFE
YEARS
15
Printer table
2014
55
21
Dell Dimension 8200
2014
2,050
14
Disk Server
%
GOOD
FACTOR
RCLND
$2,105 < Total CE acquired in 2014
2013
200
$200 < Total CE acquired in 2013
13
Nine Dell computers
2011
19,500
$19,500 < Total CE acquired in 2011
2
RadioShack TRS-III
2007
100
$100 < Total CE acquired in 2007
Computer Equipment Total
Item
Number
17
Machinery and Equipment
Year Acquired
5
New
Standard lathe
Used
2014
$21,905
Original
Cost
Ttl
LIFE
YEARS
%
GOOD
FACTOR
RCLND
3,300
$3,300 < Total M&E acquired in 2014
3
Brookings sheet bender - model 100A
2013
500
$500 < Total M&E acquired in 2013
Machinery and Equipment Total
TWForms - OK904-3A Rev 2014-09
$3,800
Ttl
Page 1 of 3 of Form 904-3A
OTC
904-A
State of Oklahoma
ASSET LISTING (GROUPED)
Tax Year
Revised 6-2014
Name of Business:
Sample Oklahoma 901 (Doug Anderson)
Address ...............:
9719 S 92 E Ave - Tulsa, OK 74133
Personal Property Account Number:
Phone:
P00000596001234
Email Address:
10
ASSESSORS USE ONLY
Year Acquired
Forklifts and Construction
6
(918) 252-1157
oklahoma@oklahoma.com
REPORT ONLY TANGIBLE ASSETS
Item
Number
2015
Taxpayers filing in TULSA County: Must complete this schedule listing like or similar items
grouped by description, year of acquisition and original cost and class. This schedule to be
filed with completed OTC Form 901 rendition.
Schedule 3-A
New
Tires for forklift
Used
Original
Cost
2014
LIFE
YEARS
%
GOOD
FACTOR
RCLND
600
$600 < Total F&C acquired in 2014
42
CASE forklift
2011
8,300
$8,300 < Total F&C acquired in 2011
Forklifts and Construction Total
Item
Number
Year Acquired
Tooling, Dies, and Molds
7
New
18
Various molds for proto-typing
2014
26
Power drill
2014
Used
$8,900
Original
Cost
Ttl
LIFE
YEARS
%
GOOD
FACTOR
RCLND
4,400
160
$4,560 < Total TDM acquired in 2014
27
Hammer and tong set
2013
1,250
$1,250 < Total TDM acquired in 2013
Tooling, Dies, and Molds Total
Item
Number
Other Assets and Trade Tools
9
Misc tools, wrenches, screwdrivers etc
Year Acquired
8
New
Used
$5,810
Original
Cost
2014
Ttl
LIFE
YEARS
%
GOOD
FACTOR
RCLND
800
$800 < Total OATT acquired in 2014
41
Multi-rack CD burner/labler
2010
1,200
$1,200 < Total OATT acquired in 2010
Other Assets and Trade Tools Total
Item
Number
7
Year Acquired
Leased To Others
9
Leased old chairs to Dairy Queen
New
Used
$2,000
Original
Cost
2014
Ttl
LIFE
YEARS
%
GOOD
FACTOR
RCLND
900
Lease Information
Asset Type : Furniture
Lessee Name : Lesse Name here
Age of Asset : 1 years
Address : lessee's address
Lease Term : 36 months
Payment : $500
Phone : lessee's phone
20
Leased mapping machine to Ralph
Lease Information
2014
300
Asset Type : Map type asset. Not sure
Lessee Name : Ralph Smith
Age of Asset : 8 years
Address : 333 Smith lane
Lease Term : 2 years
Payment : $75
Phone : (918) 232-3232
$1,200 < Total LTO acquired in 2014
Leased To Others Total
Item
Number
4
Year Acquired
Leased From Others
10
Dell Dimension
New
Used
2013
Lease Information
$1,200
Original
Cost
Ttl
LIFE
YEARS
%
GOOD
FACTOR
RCLND
0
Asset Type : Computer
Owner Name : Bev Anderson
Age of Asset : 2 years
Address : 325 Anderson Street
Lease Term : 2 years
Phone : (405) 111-3333
First Year of Lease : 2013
Payment : $25
$0 < Total LFO acquired in 2013
5
Dell Dimension Computer
2010
Lease Information
0
Asset Type : Bob's asset type
Owner Name : Bob Henderson
Age of Asset : 5 years
Address : 123 Bobby Street
Lease Term : monthly
Phone : (918) 252-1234
First Year of Lease : 2010
Payment : $250
$0 < Total LFO acquired in 2010
Leased From Others Total
TWForms - OK904-3A Rev 2014-09
$0
Ttl
Page 2 of 3 of Form 904-3A
OTC
904-A
State of Oklahoma
ASSET LISTING (GROUPED)
Tax Year
Taxpayers filing in TULSA County: Must complete this schedule listing like or similar items
grouped by description, year of acquisition and original cost and class. This schedule to be
filed with completed OTC Form 901 rendition.
Schedule 3-A
Revised 6-2014
Name of Business:
Sample Oklahoma 901 (Doug Anderson)
Address ...............:
9719 S 92 E Ave - Tulsa, OK 74133
Personal Property Account Number:
Phone:
P00000596001234
Email Address:
REPORT ONLY TANGIBLE ASSETS
29 assets
TWForms - OK904-3A Rev 2014-09
Asset Grand Totals
2015
(918) 252-1157
oklahoma@oklahoma.com
ASSESSORS USE ONLY
$60,955
Page 3 of 3 of Form 904-3A
OTC
901-F
State of Oklahoma
FREEPORT EXEMPTION DECLARATION
Revised 6-2014
Return to County Assessor - Filing Date: January 1 - March 15
Tax Year
2015
Tulsa County
NAME AND ADDRESS
USE CURRENT YEAR FORM
Firm Name ..........:
Other firm name used for Freeport Exemption
Property Address :
94132 South 92nd East Avenue, Tulsa OK 55555-5555
Mailing Address ..:
Phone Number ...:
123 S 92 E Ave, Tulsa OK 74133
T-9A
Email Address :
(918) 252-1157
School
District
oklahoma@oklahoma.com
This is a statement of goods, wares, and merchandise exempt from taxation under Article X , Section 6A of the Oklahoma Constitution.
Please note that inventory costs must include raw material, work in progress, finished goods, consigned and floor planned merchandise.
COST OF GOODS SOLD
1
Beginning inventory in Oklahoma
$
78,000
2
Add: Total purchases for Oklahoma Inventory
$
9,000
3
Add: Incoming freight charges related to line 2
$
300
4
Add: Other cost (work in process, labor, and/or other related overhead)
$
650
5
Less: Ending inventory in Oklahoma
$
6
Cost of goods sold (Sum of lines 1, 2, 3, and 4 - minus line 5)
$
87,950
AVERAGE INVENTORY
7
Monthly inventory (Enter 0 for the months with no inventory)
January
July
6,333
78,000
February
March
2,000
August
0
April
0
September
October
9,000
400
0
May
June
0
November
0
December
0
2,500
8
Total Inventory (sum of the preceding months)
$
98,233
9
Average inventory (line 8 divided by number of months in Oklahoma)
$
16,372
10
Inventory turns per year (line 6 divided by line 9)
$
5.3720
11
Months required for turnover (12 months divided by line 10)
Note: If line 11 is more than 9.0, the exemption is not allowed.
$
2.2338
PURHASES FOR OKLAHOMA INVENTORY
12
Total purchases for Oklahoma inventory (from line 2)
$
9,000
13
Less: Inventory purchases from Oklahoma vendors
$
4,000
14
Inventory purchased from out-of-state vendors (line 12 minus line 13)
$
5,000
15
Percent of out-of-state purchases (line 14 divded by line 12)
$
55.56 %
SALES FROM OKLAHOMA INVENTORY
16
Total sales from Oklahoma inventory
$
8,500
17
Less: Sales within Oklahoma
$
6,000
18
Sold and shipped out-of-state (line 16 minus line 17)
$
2,500
19
Percent of out-of-state sales (line 18 divided by line 16)
$
29.41 %
FREEPORT EXEMPTION
20
Average inventory (from line 9)
$
16,372
21
Less: Amount exempt (lower of line 15 or line 19 x line 20)
$
4,815
22
Inventory amount not exempt
$
11,557
All the above described property is located in Tulsa County, Oklahoma.
I, the undersigned officer of the above named company , corporation, or business concern do hereby declare under oath as provided by Oklahoma
Statutes that the above schedule and statements have been examined by me and to the best of my knowledge and belief is a true and complete return,
made in good faith, for the taxable year stated.
Signature
TWForms - OK901-F Rev 2014-09
Title
President
Date
01/10/2015
FORM 901/901P - Other Information
TAX YEAR 2015
Name of Business ................:
Sample Oklahoma 901 (Doug Anderson)
Address ...............................:
9719 S 92 E Ave - Tulsa, OK 74133
Personal Property Acct # ......:
P00000596001234
Usable Square Footage ........:
4000
Number of Units ...................:
4
Strip Center or Office Building:
Remington Towers III
Other Information .................:
Several assets were moved to this location from our Sapulpa plant. Please contact us if you
have any questions.
TWForms - OK901OTHER Rev 2011-11
State of Oklahoma
INTANGIBLE PERSONAL PROPERTY EXEMPTION
OTC
901-IP
Tax Year
2015
Tulsa County
(918) 596-5100
Fax (918) 596-4799
6-2014
Ken Yazel, Tulsa County Assessor, 500 S. Denver Ave., Suite 215, Tulsa, OK 74103
RE#
75253-55-55-12345
PP#
P00000596001234
T-9A
*P00000596001234*
Owner
/DBA
Mailing Address
Phone Number
Email Address
FEIN
73-1112222
Type of Business
Software Programming
Doug Anderson
North American Industry
Classification System
Sample Oklahoma 901
Are other businesses included in this rendition?
9719 S 92 E Ave
Tulsa, OK 74133
If yes, please list:
(918) 252-1157
oklahoma@oklahoma.com
Please provide the name and number of person to contact for audit purposes:
7
2
3
8
3
X
2
Yes
No
Other businesses listed here ...
Physical location if different than mailing address
94132 South 92nd East Avenue, Tulsa OK 55555-5555
Sue Jones
(918) 252-1157
REPORTING AND DOCUMENTATION
LOCALLY ASSESSED PERSONAL PROPERTY
Beginning January 1, 2013, the Oklahoma Constitution, Section 6A of Article 10, exempts intangible personal property from ad
valorem tax. The taxpayer must identify any intangible personal property which the taxpayer claims has been valued and assessed. If
the intangible personal proeprty has not been valued and assessed by the county assessor there is not a valid claim for exemption.
Documentation must be submitted with this form establishing the existence, value and prior assessment of any intangible
personal property claimed to be exempt.
INTANGIBLE PERSONAL PROPERTY LISTING
Asset Description
Original Cost
Net Book
Taxpayer's Estimate of
Fair Market Value
Totals
State of Oklahoma - County of _Tulsa_
I, _Henry James III_ under penalties of perjury, do hereby depose and say that I am _President_ of _Sample Oklahoma 901_ company; that as such I am
acquainted with the books, accounts, and affairs of said company and know that the accompanying statement to be true , correct, and complete, and that all
information requested herein has been fully and correctly given. (68 O.S. Section 2945 provides penalties for false oaths)
01/10/2015
Don't Forget
to Sign
Signature of preparer if other than taxpayer
Date
01/10/2015
Signature of taxpayer
TWForms - OK901-IP 2013-01
Date
123 CPA Avenue - Accountant City, OK 55555
Preparer's address
1234567
Preparer's identification number
(John Doe Company)
(918) 555-1212 Ext 1234
Preparer's phone number
Sample Oklahoma 901 (Doug Anderson)
Asset Listing
9719 S 92 E Ave - Tulsa, OK 74133
Cross-Tab Summary by Category & Year
Tax
Year
2015
Asset Costs for years 2014 to 1998
Computer
Equipment
Year
2014
2013
2012
2011
2010
2007
Totals
Electronic
Equipment
Forklifts and
Construction
Furniture and
Fixtures
Leased To
Others
Leasehold
Improvement
Machinery and
Equipment
Other Assets
and Trade Tools
Tooling, Dies,
and Molds
Totals
16,160
12,450
3,245
27,800
1,200
100
60,955
TWForms - AssetGrid 2008-12
2,105
200
2,245
600
2,995
19,500
950
10,000
250
1,200
400
500
3,300
500
800
4,560
1,250
8,300
1,200
100
21,905
5,240
8,900
11,200
01/10/2015
1,200
900
3,800
2,000
5,810
Page 1 of 2
Sample Oklahoma 901 (Doug Anderson)
Asset Listing
9719 S 92 E Ave - Tulsa, OK 74133
Cross-Tab Summary by Category & Year
Tax
Year
2015
Fair Market Values of All Assets (calculated)
Computer
Equipment
Electronic
Equipment
Year
Totals
1,790
1,953
11,342
2014
48
7,193
2013
1,947
2,065
2012
8,190
12,423
2011
816
2010
24
24
2007
33,863
10,052
3,900
Totals
Calculations are based on Cost, Age, Life and PV%
TWForms - AssetGrid 2008-12
Forklifts and
Construction
234
Furniture and
Fixtures
Leased To
Others
754
5,800
118
Leasehold
Improvement
855
368
435
Machinery and
Equipment
1,551
435
Other Assets
and Trade Tools
736
Tooling, Dies,
and Molds
3,101
475
4,233
816
4,467
6,672
01/10/2015
855
803
1,986
1,552
3,576
Page 2 of 2
9719 S 92 E Ave - Tulsa, OK 74133
Item#
Tax
Year
2015
Asset Listing
Sample Oklahoma 901 (Doug Anderson)
Grouped by Category, Year Acquired
Description
New/
Year Used
Acq -Age
L PV
F %
2014
2014
5 85
5 85
Calced
FMV
Cost
Manual
FMV
Category
Computer Equipment
15
21
Printer table
Dell Dimension 8200
N-1
N-1
Total for 2014
55
2,050
47
1,743
2,105
1,790
Computer Equipment
Computer Equipment
14
Disk Server
2013
U-6
5 24
200
48
Computer Equipment
13
Nine Dell computers
2011
N-4
5 42
19,500
8,190
Computer Equipment
2
RadioShack TRS-III
2007
N-8
5 24
100
24
Computer Equipment
$21,905
$10,052
2,100
145
1,827
126
2,245
1,953
Total Cost for Computer Equipment
Electronic Equipment
16
35
Blueprinting machine
Copier
2014
2014
N-1
N-1
6 87
6 87
Total for 2014
40
CAD Drafting table
2012
N-3
6 65
Total Cost for Electronic Equipment
2,995
1,947
$5,240
$3,900
Electronic Equipment
Electronic Equipment
Electronic Equipment
Forklifts and Construction
10
Tires for forklift
2014
U-5
6 39
600
234
Forklifts and Construction
42
CASE forklift
2011
N-4
6 51
8,300
4,233
Forklifts and Construction
$8,900
$4,467
350
100
500
322
92
340
950
754
Total Cost for Forklifts and Construction
Furniture and Fixtures
19
29
37
Receptionist desk
Couch
Misc furniture
2014
2014
2014
N-1
N-1
U-5
10 92
10 92
10 68
Total for 2014
Furniture and Fixtures
Furniture and Fixtures
Furniture and Fixtures
12
Old Mahogony desk
2013
U-6
10 58
10,000
5,800
Furniture and Fixtures
28
Lamps
2012
U-7
10 47
250
118
Furniture and Fixtures
$11,200
$6,672
Total Cost for Furniture and Fixtures
Leased From Others
4
Dell Dimension
Lease/Consignment Info:
2013
Leased From Others
N-2
Bev Anderson, 325 Anderson Street, (405) 111-3333
Term : 2 years
5
Dell Dimension Computer
Lease/Consignment Info:
2010
Payment/Rent : $25
First Year of Lease : 2013
Age: 2
Leased From Others
N-5
Bob Henderson, 123 Bobby Street, (918) 252-1234
Term : monthly
Payment/Rent : $250
First Year of Lease : 2010
Age: 5
Total Cost for Leased From Others
Leased To Others
7
Leased old chairs to Dairy Queen
Lease/Consignment Info:
2014 N-1
5 85
Lesse Name here, lessee's address, lessee's phone
Term : 36 months
20
Leased mapping machine to Ralph
2014 U-5
5 30
Lease/Consignment Info:
Ralph Smith, 333 Smith lane, (918) 232-3232
Term : 2 years
900
765
Leased To Others
Payment/Rent : $500
300
Age: 1
90
Payment/Rent : $75
Leased To Others
Age: 8
Total for 2014
1,200
855
Total Cost for Leased To Others
$1,200
$855
225
175
207
161
400
368
500
435
$900
$803
Leasehold Improvement
34
39
Repaired sign
Curb put in
2014
2014
N-1
N-1
10 92
10 92
Total for 2014
1
New sign
2013
N-2
10 87
Total Cost for Leasehold Improvement
Leasehold Improvement
Leasehold Improvement
Leasehold Improvement
Machinery and Equipment
17
Standard lathe
2014
U-7
10 47
3,300
1,551
Machinery and Equipment
3
Brookings sheet bender - model 100A
2013
N-2
10 87
500
435
Machinery and Equipment
$3,800
$1,986
Total Cost for Machinery and Equipment
TWForms - AssetListing 2012-05
01/10/2015
Page 1 of 2
9719 S 92 E Ave - Tulsa, OK 74133
Item#
Description
Tax
Year
2015
Asset Listing
Sample Oklahoma 901 (Doug Anderson)
Grouped by Category, Year Acquired
New/
Year Used
Acq -Age
L PV
F %
Cost
Calced
FMV
Manual
FMV
Category
Other Assets and Trade Tools
9
Misc tools, wrenches, screwdrivers etc
2014
N-1
10 92
800
736
Other Assets and Trade Tools
41
Multi-rack CD burner/labler
2010
N-5
10 68
1,200
816
Other Assets and Trade Tools
$2,000
$1,552
4,400
160
2,992
109
4,560
3,101
1,250
475
$5,810
$3,576
$60,955
$33,863
Total Cost for Other Assets and Trade Tools
Tooling, Dies, and Molds
18
26
Various molds for proto-typing
Power drill
2014
2014
N-1
N-1
3 68
3 68
Total for 2014
27
Hammer and tong set
2013
N-2
3 38
Total Cost for Tooling, Dies, and Molds
Grand Totals for All 29 Assets
TWForms - AssetListing 2012-05
01/10/2015
Tooling, Dies, and Molds
Tooling, Dies, and Molds
Tooling, Dies, and Molds
Page 2 of 2
FORM 901 INSTRUCTIONS
Who must file...
All business concerns, corporations, partnerships and professionals are required by
Oklahoma statutes to file each year a statement of taxable assets as of January 1,
which are located within this county. This rendition must be signed by an owner,
partner, officer of the corporation or a bonafide agent.
Penalties...
Failure to file by March 15th will subject the taxpayer to a mandatory penalty of 10 percent, or
a 20 percent penalty if not filed by April 15th (68 O.S. Section 2836C). If received through the
mail by this office, it must be postmarked no later than March 15th. Postage metered mail
overstamped by the Post Office after March 15th, will carry the mandatory penalty.
Taxpayers Filing Form 901 in this County...
Attach a complete detailed listing of all TANGIBLE assets used in business, grouped by
description, year acquired and original cost, and items that have zero book value, use
reporting Asset Listing 904 Schedule 3 or 3A, which is available from the county
assessor. Report ONLY TANGIBLE ASSETS.
TAX YEAR 2015
Computer Equipment ...
Items included: computer hardware, monitors, drives, and other such hardware components.
Custom software is exempt as an intangible.
Machinery and Equipment...
Items included: auto repair, agricultural, bakeries, barber and beauty shops, cleaning and
laundry, fuel storage tanks, gas pumps, medical, restaurants, signs, theaters, etc. All equipment
and machinery (forklifts, mobile yard cranes, drilling rigs, tools) is also included. Equipment
installed on trucks or trailers after purchase must also be reported. Do not list licensed vehicles
such as autos, trucks, semitrailers, boats over 10 h.p., etc.
Forklifts and Construction Equipment...
Items include: forklifts, back hoes, compactors, dozers, draglines, earth movers, graders, mobile
cranes, rollers, trenchers, etc.
Tooling, Dies and Molds...
Items include: Tooling, dies, punches, molds, patterns, jigs, etc.
North American Industry Classification System (NAICS)...
This is your six digit Federal Business Activity Code.
Trade Tools and Equipment...
Include items used by carpenters, cement finishers, craftsmen, electricians, mason, mechanics,
repair services, roofers, etc.
Location of Property...
You must file a separate rendition for each location for assessment allocation to the various
school districts.
*List lessee, address, asset type, original cost, and age of asset.
Original Cost Values or RCN...
Report the total new or used total cost or replacement cost new, including freight-in and
installation costs. Do not deduct investment credit, trade-in allowances or depreciation. If
unknown, estimate the original cost. Estimated costs will not be depreciated without
supporting documents.
Year Acquired...
This is the purchase date. Depreciation cannot be calculated unless the year acquired is
reported.
Leasehold Improvements...
Report cost and detailed description of improvements to property owned by others. Do not
report building expansions or repairs, rough plumbing or electrical service, which are included
in real estate values. Report all other items such as partitions, new store fronts, etc.
Furniture and Fixtures...
Items included: office desks, chairs, credenzas, file cabinets, table booths, shelving display
cases, racks, gondolas, retail fixtures, hotel and motel furnishings, etc.
Electronic Equipment...
Items included: calculators, copiers, drafting machines, blueprinting machines, fax machines,
postage machines, telephone equipment, typewriters, lunch room appliances, etc. Also,
include electronic and computer controls used with machinery and equipment.
TWForms - OK901INSTR Rev 2013-10
Leased to Others...
Additional sheets may be
attached, if necessary.
*List lessor, address, asset type, age of asset, and beginning year of lease.
Leased from Others...
Additional sheets
may be attached, if necessary.
Inventories...
Add your total monthly inventories. Then divide the sum by the number of months you have
inventory in this county for the year to determine your average inventory. Inventories held for
others or cosigned must be reported separately. Inventory claimed exempt must be accompanied
by a Freeport Exemption Form (901-F).
If the Business is Sold, Closed or Name Changed...
To avoid possible incorrect or duplicate assessment, taxpayers should provide information as
follows:
* Business Sold: date of sale, name and address of new owner.
* Business Closed: date of closing or date all personal property was disposed, report location
and value of any remaining property still owned on the assessing date, even if in storage.
* Business Name Change: date of change and new name.
Intangible Business Personal Property...
If any intangible property is imbedded in the reported assets the intangible property must be
identified and valued to the county assessor with supporting documentation. Supplemental Form
901-IP must be used for any submission.
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