Ariz. Admin. Code § R16-4-113
All decisions of the Board shall include:
Petitions must be filed on or before the fourth Monday in June or within fifteen (15) days of the date the Department mails the valuation of the property to the Petitioner, whichever date is later. A petition is deemed filed either (1) when actually received by the Board or (2) as of the date of the United States Postal Service postmark. All exhibits to be entered into the record at the time of the hearing must be exchanged between the parties and four (4) copies provided to the Board three (3) work days prior to the hearing.
Statutory time constraints require that hearings be scheduled on short notice. Therefore Petitioner should call the Board as soon as they decide to appeal so that a hearing date may be scheduled to best accommodate witness and travel requirements. Appeals by Private Car Companies are governed by A.R.S. § 42-745.01.
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Emergency rule adopted effective February 1, 1996, in effect for a maximum of 180 days (Supp. 96-1).
STATE BOARD OF EQUALIZATION
1501 W. WASHINGTON, SUITE #221
PHOENIX, ARIZONA 85007
5)
Basis for this Petition: ______________________________________________________________________________________________________________
________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________________
FILING AUTHORITY AND GENERAL INFORMTION:
ARS § 42-145: Annual June property valuation notification pursuant to ARS § 42-145(B) or (C).
ARS § 42-149: Property revalued after the third Monday in June on the basis of an error, omission or defect in form.
ARS § 42-745.01: Private car companies. Petition must be RECEIVED by the State Board by December 1. Hearings will be held Monday through Wednesday prior to December 10. Exhibits must be exchanged between parties and copies provided to the Board before noon on the Friday preceeding the hearing.
6) I HEREBY AFFIRM UNDER OATH THAT THE FOREGOING INFORMATION IS TRUE AND CORRECT.
________________________________________________________________________________________________________________________________
SIGNATURE OF OWNER OR AUTHORIZED ATTORNEY PRINT NAME IF DIFFERENT FROM ITEM 1 ABOVE
________________________________________________________________________________________________________________________________
ADDRESS IF DIFFERENT FROM ITEM 1 ABOVE TELEPHONE
________________________________________________________________________________________________________________________________
CITY STATE ZIP CODE
Send Top Three
Copies To:
TA 200/84
3) DATE OF DECISION BY THE DEPARTMENT OF REVENUE ________________________________________________________________________
Full Cash Limited Property Personal Property Legislative Assessment
4) Value Value Value Class Ratio
Petitioners $ $ $
Value
Department of $ $ $
Revenue Value
2) USE OF THE PROPERTY
(mine, railroad, pipeline, etc.)
1)
PROPERTY TAX
_____________________ NUMBER ____________________
DATE
_____________________________________________________________
NAME (AS LISTED ON TAX ROLL) PLEASE PRINT OR TYPE
_____________________________________________________________ (_______)____________________________
ADDRESS TELEPHONE: PRIMARY
_____________________________________________________________ (_______)____________________________
CITY STATE ZIP CODE TELEPHONE: ALTERNATE
INCOME AND EXPENSE STATEMENT
Pursuant to A.R.S. § 42-108, 42-221, 42-236 & 42-241.01
CONFIDENTIAL
• The information submitted herein is confidential and may be utilized only by the valuation authorities involved in the administrative appeals process and by the Department of Revenue for statistical purposes.
• Complete the income and expense information where applicable. Please type or print.
See reverse side for complete instructions.
DATE ____________________ COUNTY ____________________ BOOK __________ MAP __________ PARCEL __________
IF THIS IS A MULTIPLE PARCEL APPEAL CHECK HERE
AND ATTACH A LIST OF OTHER PARCELS.
CHECK PROPERTY TYPE
APARTMENT OFFICE/SHOPPING CENTER/RETAIL MINI-STORAGE WAREHOUSE
INDUST PARK/MFG/DIST WAREHOUSE MOBILE HOME/RV PARK HOTEL/MOTEL/RESORT
OTHER (MULTI-PURPOSE FORM)
OWNER’S NAME _____________________________________________________________________
ADDRESS ___________________________________________________________________________
CITY ___________________________________ STATE ___________________ ZIP ______________
TELEPHONE ( ) _________________________________
PROPERTY ADDRESS _________________________________________________________________
PRIOR YEAR PROPERTY TAXES $ _____________________________________
____________________________________________________________________________________________________________________________
PROVIDE THE FOLLOWING DATA IF THE PROPERTY HAS BEEN PURCHASED OR CONSTRUCTED WITHIN THE LAST 3 YEARS.
MARKET DATE DATE COST DATA DATE
PURCHASE AMOUNT $ _______________ _______________ LAND COST $ _________________ ________________
LESS PERSONAL PROPERTY _______________ _______________ BLDG COST _________________ ________________
REAL PROPERTY AMOUNT $ _______________ _______________ TOTAL COST $ _________________
MORTGAGE TERMS:
AMOUNT $ _______________________ INTEREST RATE _______________ LENGTH OF MORTGAGE ____________________ YEARS
Explain any unusual circumstances or conditions regarding the acquisition of the property in the following space.
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AFFIDAVIT (Pursuant to A.R.S. § 42-221)
I, __________________________________________, hereby affirm under penalty of perjury that I have reviewed the information contained in this document and any supplemental documents attached and that it is true and correct to the best of my knowledge. The source documents used to compile the information are located at ____________________________________________________. The documents may be inspected by the County Assessor or the Arizona Department of Revenue in order to verify data submitted herein.
SUBSCRIBED AND SWORN BEFORE ME
____________________________________________________ THIS _______ DAY OF ____________________, 199______
SIGNATURE OF OWNER OR REPRESENTATIVE MY COMMISSION EXPIRES
ON _______ DAY OF ____________________, 199______
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NOTARY PUBLIC
DOR 82300 (7/95)
APARTMENTS
TOTAL NUMBER OF UNITS = ______________________________ UTILITIES PAID BY:
NUMBER OF STUDIO UNITS = ______________________________
OWNER
NUMBER OF 1 BEDROOM UNITS = ______________________________
NUMBER OF 2BR/1BA UNITS = ______________________________ TENANT
NUMBER OF 2BR/2BA UNITS = ______________________________
NUMBER OF 3 BEDROOM UNITS = ______________________________
CURRENT RENT SCHEDULE
UNIT TYPE NUMBER FURN. RENT PER MONTH NUMBER UNFURN. RENT PER MONTH
STUDIO ____________________ ____________________ ____________________ ____________________
1 BEDROOM ____________________ ____________________ ____________________ ____________________
2 BR/1BA ____________________ ____________________ ____________________ ____________________
2 BR/2BA ____________________ ____________________ ____________________ ____________________
3 BEDROOM ____________________ ____________________ ____________________ ____________________
TOTAL ____________________ ____________________ ____________________ ____________________
ADDITIONAL INFORMATION/REMARKS:
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INCOME DATE SUMMARY: Provide latest three (3) year history.
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
POTENTIAL GROSS INCOME (100% OCCUPANCY) = $_______________ $_______________ $_______________
VACANCY AND COLLECTION LOSS - _______________ _______________ _______________
ADJUSTED GROSS INCOME = _______________ _______________ _______________
MISCELLANEOUS/OTHER INCOME +_______________ _______________ _______________
EFFECTIVE GROSS INCOME = _______________ _______________ _______________
TOTAL OF ALL EXPENSES - _______________ _______________ _______________
NET OPERATING INCOME = $_______________ $_______________ $_______________
NOTE: You may submit any additional documents to support the income and expense information
82300-1 (7/94) 1 of 3
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
FIXED EXPENSES
PROPERTY TAXES $________________ $________________ $________________
ANNUAL INSURANCE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
VARIABLE EXPENSES
MANAGEMENT/AGENT FEES _________________ _________________ _________________
LEASING AGENT FEES _________________ _________________ _________________
ADVERTISING/PROMOTION _________________ _________________ _________________
ADMINISTRATIVE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
UTILITIES
GAS/ELECTRIC _________________ _________________ _________________
WATER/SEWER _________________ _________________ _________________
TELEPHONE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
NORMAL REPAIRS & MAINTENANCE
BLDG. MAINTENANCE & REPAIRS _________________ _________________ _________________
PARKING LOT & COMMON AREA _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
SERVICE CONTRACTS _________________ _________________ _________________
JANITORIAL _________________ _________________ _________________
SUPPLIES _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
OTHER EXPENSES
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
82300-1 (7/94) 2 of 3
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
MAJOR REPLACEMENT/REPAIRS
INTERIOR PAINTING _________________ _________________ _________________
EXTERIOR PAINTING _________________ _________________ _________________
ROOF COVERING _________________ _________________ _________________
HEATING & COOLING _________________ _________________ _________________
FLOOR COVERING _________________ _________________ _________________
APPLIANCES _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
TOTAL OF ALL EXPENSES = _________________ _________________ _________________
SUPPLEMENTAL INFORMATION
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82300-1 (7/94) 3 of 3
OFFICE BUILDING/SHOPPING CENTER/RETAIL STORE
LEASABLE AREA: GROSS SQUARE FEET = ____________________ NET SQUARE FEET = ____________________
TYPE OF LEASE: NET ____________________ GROSS ____________________ MODIFIED GROSS ____________________
NOTE: PROVIDE ADDITIONAL LEASE INFORMATION ON THE ATTACHED TENANT LIST.
POTENTIAL CHARGES TO TENANTS: TENANT PAYS OWNER PAYS
COMMON AREA MAINTENANCE __________ __________
TAXES __________ __________
INSURANCE __________ __________
MANAGEMENT __________ __________
UTILITIES __________ __________
IF THERE ARE ANY ESCALATION CHARGES, SPECIFY ACCORDINGLY ON TENANT LIST PAGE.
IS SUBJECT PROPERTY OWNER OCCUPIED: YES NO PARTIAL
IF PARTIAL OWNER OCCUPIED, ENTER THE SQUARE FOOTAGE OF THE ARE OCCUPIED BY THE OWNER ON THE TENANT LIST. _______
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ADDITIONAL INFORMATION/REMARKS
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INCOME DATA SUMMARY: Provide latest three (3) year history.
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
POTENTIAL GROSS INCOME (100% OCCUPANCY) = $_______________ $_______________ $_______________
VACANCY AND COLLECTION LOSS (ACTUAL) - _______________ _______________ _______________
ADJUSTED GROSS INCOME = _______________ _______________ _______________
CHARGES TO TENANTS +_______________ ________________ ________________
OVERAGE RENTS +_______________ ________________ ________________
OTHER INCOME (SERVICE, MISC., ETC.) +_______________ _______________ _______________
EFFECTIVE GROSS INCOME = _______________ _______________ _______________
TOTAL OF ALL EXPENSES - _______________ _______________ _______________
NET OPERATING INCOME = $_______________ $_______________ $_______________
NOTE: You may submit any additional documents to support the income and expense information
82300-2 (7/94) 1 of 4
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
FIXED EXPENSES
PROPERTY TAXES $________________ $________________ $________________
ANNUAL INSURANCE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
VARIABLE EXPENSES
MANAGEMENT/AGENT FEES _________________ _________________ _________________
LEASING AGENT FEES _________________ _________________ _________________
ADVERTISING/PROMOTION _________________ _________________ _________________
ADMINISTRATIVE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
UTILITIES
GAS/ELECTRIC _________________ _________________ _________________
WATER/SEWER _________________ _________________ _________________
TELEPHONE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
NORMAL REPAIRS & MAINTENANCE
BLDG. MAINTENANCE & REPAIRS _________________ _________________ _________________
PARKING LOT & COMMON AREA _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
SERVICE CONTRACTS _________________ _________________ _________________
JANITORIAL _________________ _________________ _________________
SUPPLIES _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
OTHER EXPENSES
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
82300-2 (7/94) 2 of 4
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
MAJOR REPLACEMENT/REPAIRS
INTERIOR PAINTING _________________ _________________ _________________
EXTERIOR PAINTING _________________ _________________ _________________
ROOF COVERING _________________ _________________ _________________
HEATING & COOLING _________________ _________________ _________________
FLOOR COVERING _________________ _________________ _________________
ELEVATOR / ESCALATOR _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
TOTAL OF ALL EXPENSES = _________________ _________________ _________________
SUPPLEMENTAL INFORMATION
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82300-2 (7/94) 3 of 4
TENANT LIST
| NAME OF TENANT | TOTAL SQ. FT. | FROM MO./YR. | TO MO./YR. | 1ST YEAR RENT | AVG. ANNUAL INCREASE | CURRENT RENT |
| Owner Occupied | ||||||
NOTE: Use additional form, if necessary.
82300-2 (7/94) 4 of 4
MOBILE HOME/RV PARKS
TYPE OF SPACE # OF UNITS UTILITIES INCLUDED MONTHLY RENT ANNUAL RENT
Y/N
SINGLE WIDE __________ __________ __________ __________
DOUBLE WIDE __________ __________ __________ __________
TRAVEL TRAILER/RV __________ __________ __________ __________
TOTAL = __________ __________ __________ __________
ADDITIONAL INFORMATION/REMARKS:
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INCOME DATE SUMMARY: Provide latest three (3) year history.
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
POTENTIAL GROSS INCOME (100% OCCUPANCY) = $_______________ $_______________ $_______________
VACANCY AND COLLECTION LOSS - _______________ _______________ _______________
ADJUSTED GROSS INCOME = _______________ _______________ _______________
MISCELLANEOUS/OTHER INCOME +_______________ _______________ _______________
EFFECTIVE GROSS INCOME = _______________ _______________ _______________
TOTAL OF ALL EXPENSES - _______________ _______________ _______________
NET OPERATING INCOME = $_______________ $_______________ $_______________
NOTE: You may submit any additional documents to support the income and expense information
82300-3 (7/94) 1 of 3
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
FIXED EXPENSES
PROPERTY TAXES $________________ $________________ $________________
ANNUAL INSURANCE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
VARIABLE EXPENSES
MANAGEMENT/AGENT FEES _________________ _________________ _________________
LEASING AGENT FEES _________________ _________________ _________________
ADVERTISING/PROMOTION _________________ _________________ _________________
ADMINISTRATIVE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
UTILITIES
GAS/ELECTRIC _________________ _________________ _________________
WATER/SEWER _________________ _________________ _________________
TELEPHONE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
NORMAL REPAIRS & MAINTENANCE
BLDG. MAINTENANCE & REPAIRS _________________ _________________ _________________
PARKING LOT & COMMON AREA _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
SERVICE CONTRACTS _________________ _________________ _________________
JANITORIAL _________________ _________________ _________________
SUPPLIES _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
OTHER EXPENSES
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
82300-3 (7/94) 2 of 3
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
MAJOR REPLACEMENT/REPAIRS
HEATING & COOLING _________________ _________________ _________________
ROOF COVERING _________________ _________________ _________________
FLOOR COVERING _________________ _________________ _________________
PAVING _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
SUPPLEMENTAL INFORMATION
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82300-3 (7/94) 3 of 3
HOTELS-MOTELS-RESORTS
TOTAL # OF ROOMS: ______ RESTAURANT: (Y/N) _______ LOUNGE: (Y/N) _______ MEETING ROOMS: (Y/N) _______
ANNUAL OCCUPANCY RATE FOR THE PAST (3) YEARS: 199______ _______% 199______ _______% 199______ _______%
ATTACH COPY OF CURRENT ROOM/RENT RATES, IF AVAILABLE.
ADDITIONAL INFORMATION/REMARKS:
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INCOME DATE SUMMARY: Provide latest three (3) year history.
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
POTENTIAL GROSS INCOME (100% OCCUPANCY) = $_______________ $_______________ $_______________
VACANCY AND COLLECTION LOSS (ACTUAL) - _______________ _______________ _______________
ADJUSTED GROSS INCOME = _______________ _______________ _______________
FOOD/BEVERAGE INCOME +_______________ _______________ _______________
TELEPHONE INCOME +_______________ _______________ _______________
OTHER INCOME (SERVICE, MISC., ETC.) +_______________ _______________ _______________
EFFECTIVE GROSS INCOME = _______________ _______________ _______________
TOTAL OF ALL EXPENSES - _______________ _______________ _______________
NET OPERATING INCOME = $_______________ $_______________ $_______________
NOTE: You may submit any additional documents to support the income and expense information
82300-4 (7/94) 1 of 3
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
FIXED EXPENSES
PROPERTY TAXES $________________ $________________ $________________
ANNUAL INSURANCE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
VARIABLE EXPENSES
MANAGEMENT/AGENT FEES _________________ _________________ _________________
LEASING AGENT FEES _________________ _________________ _________________
ADVERTISING/PROMOTION _________________ _________________ _________________
ADMINISTRATIVE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
UTILITIES
GAS/ELECTRIC _________________ _________________ _________________
WATER/SEWER _________________ _________________ _________________
TELEPHONE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
NORMAL REPAIRS & MAINTENANCE
BLDG. MAINTENANCE & REPAIRS _________________ _________________ _________________
PARKING LOT & COMMON AREA _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
SERVICE CONTRACTS _________________ _________________ _________________
JANITORIAL _________________ _________________ _________________
SUPPLIES _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
OTHER EXPENSES
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
82300-4 (7/94) 2 of 3
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
MAJOR REPLACEMENT/REPAIRS
INTERIOR PAINTING _________________ _________________ _________________
EXTERIOR PAINTING _________________ _________________ _________________
ROOF COVERING _________________ _________________ _________________
HEATING & COOLING _________________ _________________ _________________
FLOOR COVERING _________________ _________________ _________________
PAVING _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
TOTAL OF ALL EXPENSES = _________________ _________________ _________________
SUPPLEMENTAL INFORMATION
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82300-4 (7/94) 3 of 3
MINI-STORAGE WAREHOUSE
Property Name: ____________________________________________________________________________________________________
Total Number of Units: ____________________
UNIT SIZES RENT PER MONTH NUMBER OF UNITS
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
__________ ft. x __________ ft. $ _______________ _________________
Does manager live on site? Y/N __________
ADDITIONAL INFORMATION/REMARKS:
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INCOME DATE SUMMARY: Provide latest three (3) year history.
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
POTENTIAL GROSS INCOME (100% OCCUPANCY) = $_______________ $_______________ $_______________
VACANCY AND COLLECTION LOSS - _______________ _______________ _______________
ADJUSTED GROSS INCOME = _______________ _______________ _______________
MISCELLANEOUS/OTHER INCOME +_______________ _______________ _______________
EFFECTIVE GROSS INCOME = _______________ _______________ _______________
TOTAL OF ALL EXPENSES - _______________ _______________ _______________
NET OPERATING INCOME = $_______________ $_______________ $_______________
NOTE: You may submit any additional documents to support the income and expense information
82300-5 (7/94) 1 of 3
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
FIXED EXPENSES
PROPERTY TAXES $________________ $________________ $________________
ANNUAL INSURANCE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
VARIABLE EXPENSES
MANAGEMENT/AGENT FEES _________________ _________________ _________________
LEASING AGENT FEES _________________ _________________ _________________
ADVERTISING/PROMOTION _________________ _________________ _________________
ADMINISTRATIVE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
UTILITIES
GAS/ELECTRIC _________________ _________________ _________________
WATER/SEWER _________________ _________________ _________________
TELEPHONE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
NORMAL REPAIRS & MAINTENANCE
BLDG. MAINTENANCE & REPAIRS _________________ _________________ _________________
PARKING LOT & COMMON AREA _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
SERVICE CONTRACTS _________________ _________________ _________________
JANITORIAL _________________ _________________ _________________
SUPPLIES _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
OTHER EXPENSES
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
82300-5 (7/94) 2 of 3
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
MAJOR REPLACEMENTS/REPAIRS
ROOF COVERING _________________ _________________ _________________
PAVING _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
TOTAL OF ALL EXPENSES = _________________ _________________ _________________
SUPPLEMENTAL INFORMATION
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82300-5 (7/94) 3 of 3
INCOME DATA FOR:
INDUSTRIAL PARK MANUFACTURING DISTRIBUTION WAREHOUSE
PROPERTY NAME: _________________________________________________________________________________________________
FILL IN THE APPLICABLE INFORMATION FOR THE PROPERTY NAMED ABOVE:
LEASABLE AREA: GROSS SQUARE FEET = _______________________ NET SQUARE FEET = ____________________
TYPE OF LEASE: NET __________ GROSS __________ MODIFIED GROSS __________ Other __________ (Explain Below)
PERCENTAGE OF OFFICE SPACE = __________% OR __________ SQUARE FEET
LAND TO BUILDING RATIO = __________ PARKING RATIO = __________
POTENTIAL CHARGES TO TENANTS: TENANT PAYS OWNER PAYS
COMMON AREA MAINTENANCE _____________ _____________
TAXES _____________ _____________
INSURANCE _____________ _____________
MANAGEMENT _____________ _____________
UTILITIES _____________ _____________
IF THERE ARE ANY ESCALATION CHARGES, SPECIFY ACCORDINGLY ON TENANT LIST PAGE.
IS SUBJECT PROPERTY OWNER OCCUPIED YES NO PARTIAL
IF PARTIAL OWNER OCCUPIED, ENTER THE SQUARE FOOTAGE OF THE AREA OCCUPIED BY THE OWNER ON THE TENANT LIST.
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ADDITIONAL INFORMATION/REMARKS:
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INCOME DATE SUMMARY: Provide latest three (3) year history.
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
POTENTIAL GROSS INCOME (100% OCCUPANCY) = $_______________ $_______________ $_______________
VACANCY AND COLLECTION LOSS (ACTUAL) - _______________ _______________ _______________
ADJUSTED GROSS INCOME = _______________ _______________ _______________
CHARGES TO TENANTS +_______________ _______________ _______________
OTHER INCOME (SERVICE, MISC., ETC.) +_______________ _______________ _______________
EFFECTIVE GROSS INCOME = _______________ _______________ _______________
TOTAL OF ALL EXPENSES - _______________ _______________ _______________
NET OPERATING INCOME = $_______________ $_______________ $_______________
NOTE: You may submit any additional documents to support the income and expense information
82300-6 (7/94) 1 of 4
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
FIXED EXPENSES
PROPERTY TAXES $________________ $________________ $________________
ANNUAL INSURANCE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
VARIABLE EXPENSES
MANAGEMENT/AGENT FEES _________________ _________________ _________________
LEASING AGENT FEES _________________ _________________ _________________
ADVERTISING/PROMOTION _________________ _________________ _________________
ADMINISTRATIVE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
UTILITIES
GAS/ELECTRIC _________________ _________________ _________________
WATER/SEWER _________________ _________________ _________________
TELEPHONE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
NORMAL REPAIRS & MAINTENANCE
BLDG. MAINTENANCE & REPAIRS _________________ _________________ _________________
PARKING LOT & COMMON AREA _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
SERVICE CONTRACTS _________________ _________________ _________________
JANITORIAL _________________ _________________ _________________
SUPPLIES _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
OTHER EXPENSES
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
82300-6 (7/94) 2 of 4
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
MAJOR REPLACEMENTS/REPAIRS
HEATING AND COOLING _________________ _________________ _________________
EXTERIOR PAINTING _________________ _________________ _________________
ROOF COVERING _________________ _________________ _________________
PAVING _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
TOTAL OF ALL EXPENSES = _________________ _________________ _________________
SUPPLEMENTAL INFORMATION
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82300-6 (7/94) 3 of 4
TENANT LIST
| NAME OF TENANT | TOTAL SQ. FT. | FROM MO./YR. | TO MO./YR. | 1ST YEAR RENT | AVG. ANNUAL INCREASE | CURRENT RENT |
| Owner Occupied | ||||||
NOTE: Use additional form, if necessary.
82300-6 (7/94) 4 of 4
MULTI-PURPOSE FORM
PROPERTY NAME: _________________________________________________________________________________________________
FILL IN THE APPLICABLE INFORMATION FOR THE PROPERTY NAMED ABOVE:
LEASABLE AREA: GROSS SQUARE FEET = _______________________ NET SQUARE FEET = ____________________
TYPE OF LEASE: NET __________ GROSS __________ MODIFIED GROSS __________ Other __________ (Explain Below)
PERCENTAGE OF OFFICE SPACE = __________% OR __________ SQUARE FEET
LAND TO BUILDING RATIO = __________ PARKING RATIO = __________
POTENTIAL CHARGES TO TENANTS: TENANT PAYS OWNER PAYS
COMMON AREA MAINTENANCE _____________ _____________
TAXES _____________ _____________
INSURANCE _____________ _____________
MANAGEMENT _____________ _____________
UTILITIES _____________ _____________
IF THERE ARE ANY ESCALATION CHARGES, SPECIFY ACCORDINGLY ON TENANT LIST PAGE.
IS SUBJECT PROPERTY OWNER OCCUPIED YES NO PARTIAL
IF PARTIAL OWNER OCCUPIED, ENTER THE SQUARE FOOTAGE OF THE AREA OCCUPIED BY THE OWNER ON THE TENANT LIST.
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ADDITIONAL INFORMATION/REMARKS:
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INCOME DATE SUMMARY: Provide latest three (3) year history.
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
POTENTIAL GROSS INCOME (100% OCCUPANCY) = $_______________ $_______________ $_______________
VACANCY AND COLLECTION LOSS (ACTUAL) - _______________ _______________ _______________
ADJUSTED GROSS INCOME = _______________ _______________ _______________
CHARGES TO TENANTS +_______________ _______________ _______________
OTHER INCOME (SERVICE, MISC., ETC.) +_______________ _______________ _______________
EFFECTIVE GROSS INCOME = _______________ _______________ _______________
TOTAL OF ALL EXPENSES - _______________ _______________ _______________
NET OPERATING INCOME = $_______________ $_______________ $_______________
NOTE: You may submit any additional documents to support the income and expense information
82300-7 (7/94) 1 of 4
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
FIXED EXPENSES
PROPERTY TAXES $________________ $________________ $________________
ANNUAL INSURANCE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
VARIABLE EXPENSES
MANAGEMENT/AGENT FEES _________________ _________________ _________________
LEASING AGENT FEES _________________ _________________ _________________
ADVERTISING/PROMOTION _________________ _________________ _________________
ADMINISTRATIVE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
UTILITIES
GAS/ELECTRIC _________________ _________________ _________________
WATER/SEWER _________________ _________________ _________________
TELEPHONE _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
NORMAL REPAIRS & MAINTENANCE
BLDG. MAINTENANCE & REPAIRS _________________ _________________ _________________
PARKING LOT & COMMON AREA _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
SERVICE CONTRACTS _________________ _________________ _________________
JANITORIAL _________________ _________________ _________________
SUPPLIES _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
OTHER EXPENSES
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
82300-7 (7/94) 2 of 4
EXPENSE DATA
PROVIDE 3-YEAR HISTORY
Last Year 2 Years Ago 3 Years Ago
199_____ 199_____ 199_____
MAJOR REPLACEMENTS/REPAIRS
HEATING AND COOLING _________________ _________________ _________________
INTERIOR PAINTING _________________ _________________ _________________
EXTERIOR PAINTING _________________ _________________ _________________
ROOF COVERING _________________ _________________ _________________
FLOOR COVERING _________________ _________________ _________________
PAVING _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
______________________________ _________________ _________________ _________________
TOTAL = _________________ _________________ _________________
TOTAL OF ALL EXPENSES = _________________ _________________ _________________
SUPPLEMENTAL INFORMATION
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82300-7 (7/94) 3 of 4
TENANT LIST
| NAME OF TENANT | TOTAL SQ. FT. | FROM MO./YR. | TO MO./YR. | 1ST YEAR RENT | AVG. ANNUAL INCREASE | CURRENT RENT |
| Owner Occupied | ||||||
NOTE: Use additional form, if necessary.
82300-7 (7/94) 4 of 4
Emergency rule adopted effective February 1, 1996, in effect for a maximum of 180 days (Supp. 96-1).
Emergency rule adopted effective February 1, 1996, in effect for a maximum of 180 days (Supp. 96-1).