CITY OF COVINGTON COMMISSIONER OF THE REVENUE CITYHALL- 333 W. LOCUST STREET PO. DRAWER 58-COVINGTON, VIRGINIA24426 TELEPHONE: (540) 965-6350-FAX (540) 965-6365 www.covingion.va.us YEAR, RETURN OF TANGIBLE PERSONAL PROPERTY & MACHINERY & TOOLS BUSINESS TAXPAYERI NAME/ADDRESS. (PLEASE CORRECT IF NECESSARY) FEDEBALI IDENTEICATONHO DATE DUE: OHSCIALS SECUHIYND Penalty fort failure tot file a return by due date shown above, shall be ten percent oft the tax assessable on such return or ten dollars, whichever is greater; provdedhowevez,hat. the penalty shall in no case exceed the amount of the tax assessable. ENTER SCHEDULE A YEAR. DISPOSAL LENGTH & WIDTH BOATSS TRAILERS NOTE: IF YOU DID NOT OWN PROPERTY LISTED ON JANUARY1 DATE FOR OFFICE DISPOSALDATE USEONLY PROPERTY DESCRIPTION VEHICLE IDENTIFICATION NUMBER MAKE & MODEL WEIGHT COST MOBILE HOMES. MO. DAY YB. SCHEDULE B YEAR NOTE: ADD/ ANY VEHICLES, BOATS, BOAT TRAILERS, MOBILE HOMES, MOTORCYCLES, OWNED JANUARY1ANDI NOTI LISTED ABOVE, ENTER PURCHASE DATE FOR OFFICE USEONLY PROPERTY DESCRIPTION PURCHASE DATE VEHICLE IDENTIFICATION NUMBER LENGTHS WIOTH: BOATSR TRAILERS MAKE & MODEL WEIGHT COST MOBILE HOMES, MO. DAY YR. SCHEDULE C TYPE OF PROPERTY (Attach ltemized Listings) ORIGINAL ACQUISITION COST OF PROPERTY (DONOTUSE DEPRECIATED VALUES IN THIS SCHEDULE) FOR OFFICE USE ONLY ORIGINAL COST TAXABLE PORTION OF ORIGINAL COST 1. FURNITURE KFIXTURES,OFFICE MACHINES. PROFESSIONAL EQUIPMENT, SHOP TOOLS, MACHINERY NOT USED IN MANUFACTURING, MINING, RADIO. TELEVISION BUSINESS 2. MACHINERY AND TOOLS USED NAMANUFACTURING MINING, RADIO, TELEVISION BROADCASTING: OR DAIRY BUSINESS, 3 ALLOTHER: TANGIBLE PERSONAL PROPERTY SCHEDULE , DECLARATION OF DO YOU HAVE ANY HEAVY CONSTRUCTION EQUIPMENT, LEASED EQUIPMENT, submitted on this return and attachments are true, full, and correct to the best of my knowledge and beliel. person willfully to subscribe a return SIGNATURE OF TAXPAYER, OFFICER, AGENT IFYES, PLEASE ATTACH: SCHEDULE(S) FARM MACHINERY, FARM ANIMALS OR AIRCRAFT2 YES NO loertily that unless otherwise indicated as personal use, the vehicles listed herein are for business use. declare that the statements and ligures NOTE I is a misdemeanor for any whicht he does not believe tot be true and (Code of VA: Sec. 58,1-11) DATE TELEPHONE TAXPAYER corect as to every material matter TITLE