Business Personal Property Return (File this tax return between October 1 and December 31 with the above taxing official)

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ADV-40 6/07 County: Taxing Official: Mailing Address: Tax Year Telephone Number: Business Personal Property Return (File this tax return between October 1 and December 31 with the above taxing official) Owner s Name: Mailing Address: For office use only Doing Business As: Business Address: Landowner s Name: Business Type: PRC No. Account No. City School Dist. Business ID No. Date Established: (Make necessary corrections above.) Title 40, Chapter 7, Code of Alabama 1975, requires that every person report to the county taxing official each year a complete list of all business personal property owned by the taxpayer on October 1 of the tax year except property which is or may be assessed by the Alabama Department of Revenue. This form must be completely filled out and all instructions followed in order to complete the assessing process for business personal property. State law requires that this form be signed by the taxpayer or official agent. 1. Complete the spaces provided above for doing business as (if different from the owner s name) and provide the business address. 2. Provide the name of the landowner. 3. Also provide the business type such as restaurant, department store, etc., and the date the business was established. 4. A complete itemized listing of all personal property owned on October 1 or a copy of the depreciation schedule used in preparing your income tax return listing the property owned by the taxpayer at the close of the fiscal year next preceding October 1 must be provided. The depreciation schedule must be adjusted for additions and deletions so that it will contain property owned by the business on the October 1 lien date. Regardless of the reporting method chosen, you must provide the name or type of personal property, the year of acquisi - tion, the cost when acquired, and any property which has been fully depreciated but was still owned on October 1. The reported cost should include invoice price, freight, and installation cost, sales and/or use tax, extra foundations necessary to support the equipment, and other cost incurred for the use of the property. If you own property in more than one taxing jurisdiction within the county you must identify the property in each jurisdiction. PART A must be used to list your personal property or a separate schedule may be attached.

5. The itemized list should include all fixed assets, including but not limited to, furniture, fixtures, computers, machinery, equipment, unlicensed motor vehicles, and add-on equipment. Multiple items of the same type of property acquired in the same year may be listed together. For example: Type of Property Date Acquired Acquisition Cost 10 IBM Typewriters 5/23/84 $10,000 4 IBM Typewriters 2/12/86 5,200 6. Supplies and materials used in the operations of the business that are NOT for sale are taxable and must be reported. (i.e., office supplies, spare parts, and other consumable items.) What was the cost of supplies and materials on hand as of October 1? $ (or monthly average) 7. Do you have licensed motor vehicles having add-on or specialized equipment (i.e. dump bodies, box type bodies, cement drums, etc.) affixed to them? Yes No If yes, and you are able to separate the cost of the add-on equipment from the total cost of the motor vehicle, complete PART A. If you are unable to separate the cost of the add-on equipment, complete PART B. 8. Do you own aircraft? Yes No If yes, complete PART C. 9. Do you have a construction in progress or holding account? Yes No If yes, complete PART D using cost as of October 1. 10. Do you lease or rent any items of personal property from someone such as machinery, equipment, computers, furniture, fixtures, aircraft, or motor vehicles? Yes No If yes, complete PART E (Statement of Leased or Rented Personal Property). 11. LEASING COMPANIES having equipment located in this county must attach a complete listing of personal property as stated in item 4. Include with this listing the lessee and address or physical location of each item of personal property. 12. Do you have personal property in your possession or located on your premises that is owned by someone else, excluding any leased or rented equipment listed in Part E? Yes No If yes, complete PART F (Statement of Other Personal Property Located on Your Premises). 13. Check category below in which your business belongs? Single Proprietor Partnership Alabama Corporation Out of State Corporation 14. If there is personal property listed on this form you feel should be exempt, please note and give reasons. 15. Person to contact if additional information is required. Day Time Phone No. ( ) NOTICE: All Business Personal Property Returns are subject to audit and appropriate penalties as found in Title 40, Chapter 7, Code of Alabama 1975. I hereby affirm that to the best of my knowledge and belief this listing including any accompanying statements, schedules, and other information is true and complete. All forms not completely filled out and signed will be returned. Date Signed Title

PART A Statement of Business Personal Property (Furniture, Fixtures, Computers, Machinery, Equipment, Unlicensed Motor Vehicles, and Add-On Equipment) FOR OFFICE USE ONLY SUPPLIES ITEM COMPOSITE VALUE

PART B Statement of Motor Vehicles with Add-On and Specialized Equipment This section is to be used to list licensed commercial motor vehicles having add-on or specialized equipment affixed to the vehicle, when the owner is unable to separate the cost of the added value equipment from that of the cab and chassis. This equipment includes but is not limited to: box type bodies, concrete mixer drums, dumping mechanisms, wrecker rigs, propane and petroleum tanks, refrigeration equipment, limousine and hearse bodies, etc. If the owner is able to make the separation, the added value equipment must be reported on Schedule A. Equipment and bodies added to a vehicle after it leaves the original manufacturer are not included in the values used in computing the property tax collected at the time of vehicle registration which are published in the Alabama Uniform Motor Vehicle Manual by the Alabama Department of Revenue. Purchase Price must include all cost associated with the purchase of the motor vehicle, including any tradein value. If additional space is needed, a separate schedule may be attached. YEAR 1995 MAKE Mack RD6885 TAG 4X3724 COMPLETE VEHICLE IDENTIFICATION (VIN) 1 J 2 P 6 7 C 9 R M 0 2 1 5 7 2 1 VEHICLE DESCRIPTION Dump Truck 08/02/94 PURCHASE PRICE $88,600 PART B-1 Statement of Truck Trailers, Tractor Trailers and Semi-Trailers for Which the Owner Has Obtained a Permanent License Plate This section is to be used to list truck trailers, tractor trailers and semi-trailers, for which the owner has purchased a permanent trailer tag from the county where the property is based. Pursuant to Act #2006-276 passed by the Alabama Legislature during the 2006 regular session, all truck trailer, tractor trailer and semi-trailer owners purchasing a license plate upon payment of a one-time fee per license plate shall assess the property on this return annually between October 1 and December 31. If additional space is needed, a separate schedule may be attached. YEAR 2005 MAKE Great Dane Van TAG A095200 8KL249 SERIAL TRAILER DESCRIPTION Drop Frame YY 11/09/2005 LENGTH 43 ft.

PART C Statement of Aircraft (Airplanes, Airships, Hot Air Balloons, and Avionic Equipment) AIRPLANES AND AIRSHIPS: AIRCRAFT SERIAL YEAR MAKE ACQUISITION DATE ACQUISITION HOT AIR BALLOONS: SUGGESTED LIFE OF ENVELOPE HOURS ENVELOPE USED AVIONIC EQUIPMENT (other than standard operating equipment): ITEM COMPOSITE OFFICE USE ONLY MARKET VALUE PART D Statement of Personal Property Carried As Construction in Progress ITEM AS OF OCTOBER 1 ANTICIPATED TOTAL ANTICIPATED IN SERVICE DATE Computers Equipment Machinery Furniture Fixtures Other

PART E Statement of Leased or Rented Personal Property (Furniture, Fixtures, Computers, Machinery, Equipment, Aircraft, and Motor Vehicles) NAME AND ADDRESS OF LESSOR TYPE AND QUANTITY DATE OF LEASE TERM OF LEASE ANNUAL RENT PART F Statement of Other Personal Property Located on Your Premises NAME OF OWNER ADDRESS AREA OCCUPIED TYPE OF PROPERTY