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BUSINESS PROPERTY STATEMENT FOR 2013: FILE RETURN BY APRIL

The first set of indicators focuses on formal accounts; the mechanics of the use of these accounts ( frequency of use, mode of access); the purpose of these accounts (personal or business, receipt of payments from work, government, or family); barriers to account use; and alternatives to formal accounts (mobile money). The account penetration indicator measures individual or joint ownership of formal accounts—accounts at a formal financial institution such as a bank, credit union, co- operative, post office, or microfinance institution. It includes those who report having a debit or ATM card tied to an account. Indicators relating to the receipt of. | BOE-571-L P1 REV. 18 05-12 BUSINESS PROPERTY STATEMENT FOR 2013 Declaration of costs and other related property information as of 12 01 A.M. January 1 2013 FILE RETURN BY APRIL 1 2013 NAME AND MAILING ADDRESS Make necessary corrections to the printed name and mailing address r Required Assessment Number I Business Address Sonoma County Assessor 585 Fiscal Dr. Rm 104 Santa Rosa Ca 95403 707 565-1330 RETURN THIS ORIGINAL FORM. COPIES WILL NOT BE ACCEPTED. FILE A SEPARATE STATEMENT FOR EACH LOCATION. L J PART I GENERAL INFORMATION f. Enter name and telephone number of authorized person to contact at location of accounting records g. During the period of January 1 2012 through December 31 2012 1 Did any individual or legal entity corporation partnership limited liability company etc. acquire a controlling interest see instructions for definition in this business entity Yes No 2 If YES did this business entity also own real property see instructions for definition in California at the time of the acquisition Yes No 3 If YES to both questions 1 and 2 filer must submit form BOE-100-B Statement of Change in Control and Ownership of Legal Entities to the State Board of Equalization. See instructions for filing requirements. COMPLETE a THRU g a. Enter type of business b. Enter local telephone number FAX number E-Mail Address optional c. Do you own the land at this business location Yes No If yes is the name on your deed recorded as shown on this statement Yes No d. When did you start business at this location DATE If your business name or location has changed from last year enter the former name and or location e. Enter location of general ledger and all related accounting records include zip code PART II DECLARATION OF PROPERTY BELONGING TO YOU attach schedule for any adjustment to cost COST omit cents see instructions ASSESSOR S USE ONLY 1. Supplies 2. Equipment From line 35 3. Equipment out on lease rent or conditional sale to others Attach Schedule 4. Bldgs. Bldg. Impr.