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                                                                                                                                                        2021
COUNTY OF                                                                               North Carolina                          BUSINESS PERSONAL PROPERTY LISTING
FOR DEPARTMENT          ACCOUNT NUMBER        DATE                                TWP       DISTRICT                                 CITY                 PENALTY           VALUE
USE ONLY
              a
1                    2                      3                                     4                                          5               6                       7
8                    B                      D                                     E                                          F               TOTAL
Business Legal Name or Individual’s Name                                                                                       PRINCIPAL BUSINESS
                                                                                                                               IN THIS COUNTY
Trade Name or DBA                                                                                                              SIC # OR NAICS CODE
                                                                                                                               DATE BUSINESS BEGAN IN THIS COUNTY
Address                                                                                                                        DATE BUSINESS (FISCAL) YEAR ENDS

City                                                                              State Zip                                    FILL IN APPLICABLE CIRCLE:
                                                                                                                               PARTNERSHIP        SOLE                  UNINCORPORATED
                                                                                                                               LLC                PROPRIETORSHIP        ASSOCIATION
                                                                                                                               CORPORATION        OTHER (SPECIFY)
OTHER N.C. COUNTIES WHERE PERSONAL PROPERTY IS LOCATED
                                                                                                                               FILL IN APPLICABLE CIRCLE:  BUSINESS CATEGORY
                                                                                                                               RETAIL             WHOLESALE            MANUFACTURING
CONTACT PERSON FOR AUDIT                                                                                                       SERVICE            LEASING/RENTAL       FARMING
                                                                                                                               OTHER (SPECIFY)
ADDRESS & PHONE
                                                                                                                               IF OUT OF BUSINESS COMPLETE THIS SECTION
CONTACT PERSON FOR PAYMENT & PHONE                                                                                             DATE CEASED

PHYSICAL ADDRESS                                                                                                               FILL IN APPLICABLE CIRCLE: 
                                                                                                                               SOLD          CLOSED            BANKRUPT       OTHER
REAL ESTATE OWNED BY                                                                                                           SOLD EQUIPMENT, FIXTURES,
                                                                                                                               SUPPLIES TO
NAME IN WHICH BUSINESS WAS LISTED LAST YEAR                                                                                    BUYER’S ADDRESS & PHONE
NOTE:  Business owners who acquired an existing business in the previous year must contact the county  tax office for 
        important listing instructions.  Click on the link below for a list of county tax office phone numbers and addresses.
SCHEDULE  A                                   PERSONAL PROPERTY - SEE INSTRUCTIONS
YEAR              GROUP (1) MACHINERY & EQUIPMENT                                       YEAR                                 GROUP (3) OFFICE FURNITURE & FIXTURES
ACQUIRED                                                                                ACQUIRED
         PRIOR YR. COST  ADDITIONS       DELETIONS    CURR. YR. COST                                                  PRIOR YR. COST ADDITIONS            DELETIONS    CURR. YR. COST
2020                                                                                    2020
2019                                                                                    2019
2018                                                                                    2018
2017                                                                                    2017
2016                                                                                    2016
2015                                                                                    2015
2014                                                                                    2014
2013                                                                                    PRIOR
2012                                                                                    TOTAL
2011                                                                                    YEAR                                   GROUP (4) COMPUTER EQUIPMENT
2010                                                                                    ACQUIRED
                                                                                                                      PRIOR YR. COST ADDITIONS            DELETIONS    CURR. YR. COST
2009                                                                                    2020
2008                                                                                    2019
2007                                                                                    2018
2006                                                                                    2017
2005                                                                                    PRIOR
PRIOR                                                                                   TOTAL
TOTAL
                                                                                        DO NOT REMIT THIS FORM TO NC DEPARTMENT OF REVENUE
         GROUP (2) CONSTRUCTION IN PROGRESS                                                     County addresses and additional schedules are available at:
        LIST TOTAL OF ALL PERSONAL PROPERTY EXPENDITURES IN CIP ACCOUNT                       https://www.ncdor.gov/documents/north-carolina-county-assessors-list
         ON JANUARY 1, BUT NOT INCLUDED ABOVE - ITEMIZE IN SCHEDULE G
TOTAL CIP:  $                                                                                                                  Send to appropriate county tax office.



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SCHEDULE  A - CONTINUED                   PERSONAL PROPERTY - SEE INSTRUCTIONS
                                                                                                                                    Capitalization 
 YEAR GROUP (5) IMPROVEMENTS TO LEASED PROPERTY                                 YEAR   GROUP (6) EXPENSED ITEMS                      Threshold a
ACQUIRED                                                                       ACQUIRED
         PRIOR YR. COST ADDITIONS         DELETIONS             CURR. YR. COST         PRIOR YR. COST          ADDITIONS     DELETIONS         CURR. YR. COST
 2020                                                                           2020
 2019                                                                           2019
 2018                                                                           2018
 2017                                                                           2017
 2016                                                                           2016
 2015                                                                           2015
 2014                                                                           2014
 2013                                                                           2013
 2012                                                                          TOTAL
 2011                                                                          OTHER SCHEDULE A PROPERTY
 2010                                                                           Preparers of this listing form with costs to report that do not fit into any of
 2009                                                                           the seven (7) groups for Schedule A should use Schedule A-1 or A-2 to
                                                                                report those costs. The county tax office should be contacted and made
 2008                                                                           aware of this special reporting of costs prior to usage.
 2007                                                                                                                            YES     NO
                                                                                Do you have other schedule A property?
PRIOR
                                                                                                                                               A-1 or A-2
TOTAL                                                                                                       If yes, attach schedule  a

 GROUP (7) SUPPLIES             LIST COST ON HAND AS OF JANUARY 1
                                                                COST                                                                               COST
1.  OFFICE, MAINTENANCE, JANITORIAL, MEDICAL, DENTAL, BARBER                   5.  RENTAL ITEMS NOT SOLD IN THE NORMAL COURSE OF BUSINESS
  AND BEAUTY SUPPLIES                                                                  AND NOT LISTED ELSEWHERE IN SCHEDULE A
2.  FUELS HELD FOR CONSUMPTION                                                 6.  ALL OTHER MISCELLANEOUS SUPPLIES NOT LISTED ABOVE
3.  REPLACEMENT PARTS AND SPARE PARTS                                          TOTAL
4.  RESTAURANT AND HOTEL ITEMS SUCH AS LINENS, CLEANING SUPPLIES
  AND COOKWARE NOT LISTED ELSEWHERE IN SCHEDULE A
SCHEDULE  B                     VEHICULAR EQUIPMENT, MOBILE HOMES AND MOBILE OFFICES
If you answer yes to any of questions 1-7 below, you must attach the appropriate schedule which corresponds with the equipment type listed below.  If you an-
swer yes to any of questions 1,2, 3, or 4, attach Schedule B-1, attach Schedule B-2 for watercraft, attach Schedule B-3 for mobile homes or mobile offices, and 
attach Schedule B-4 for aircraft.  Indicate the quantity of short-term rental vehicles owned for question 8.
 1.  Does your business own any unregistered motor vehicles?                           YES                  NO
 2.  Does your business own any multi-year or permanently registered trailers?         YES                  NO If yes, attach schedule             a   B-1
 3.  Does your business own any special bodies on vehicles?                            YES                  NO
 4.  Does your business own any IRP (International Registration Plan) plated vehicles? YES                  NO
  NOTE:  Effective January 1, 2014, IRP plated vehicles are required to be listed with the local county tax office as part of the business personal property listing 
  form process, unless they are already being reported as part of your public service valuation with the N.C. Department of Revenue.

 5.  Does your business own any watercraft or engines for watercraft?                  YES                  NO If yes, attach schedule             a   B-2

 6.  Does your business own any mobile homes or mobile offices?                        YES                  NO If yes, attach schedule             a   B-3

 7.  Does your business own any aircraft?                                              YES                  NO If yes, attach schedule             a   B-4
 8.  Does your business own any vehicles held for short-term rental?                   YES                  NO Quantity
                                                                                                                             a

SCHEDULE  C LEASED PROPERTY OR OTHER PROPERTY IN YOUR POSSESSION THAT IS OWNED BY OTHERS
N.C.G.S. 105-315 and 105-316 require every person having custody of taxable tangible personal property that has been entrusted to them by another for any 
business purpose to furnish a separate list containing the name and address of the owner, along with a description of the property.  If you answer yes to one of 
the following three questions, or are otherwise required to supply this list, you must return the list or separate Schedule C-1 by January 15.
 1.  Does your business hold any leased property owned by another party (are you a lessee)?                                  YES         NO
 2.  Do you have any property used by your business, or in your possession, that is owned by others?                         YES         NO
 3.  Do you operate a mobile home park, campground, marina, aircraft storage facility, or similar business?                  YES         NO



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SCHEDULE  D                                          SEPARATELY SCHEDULED PROPERTY

1.  Does your business own any artwork, displays, statues, or other personal property that is separately                           YES           NO
   scheduled for insurance purposes?
   Please describe the items and estimated value of items if applicable.

SCHEDULE  E                                                     FARM EQUIPMENT
Does your business own any tractors, implements, bulk barns, and/or other farm equipment?                                      YES         NO      Cost on Schedule A                     
If so, list and attach separate Schedule E-1.  If listed by cost on Schedule A, indicate above, but still include information on separate Schedule E-1. 

SCHEDULE  F                                          INTANGIBLE PERSONAL PROPERTY
Session Law 2018-98 repealed the taxation of a leasehold interest in exempt real property, effective July 1, 2019.  Schedule F is no longer applicable and will 
be reserved for future use.

SCHEDULE  G                                          ACQUISITIONS AND DISPOSALS DETAIL

Acquisitions and disposals detail of machinery, equipment, furniture and fixtures, computer equipment, and improvements to leased property in the prior 
year.   If there is not enough room below, attach separate Schedule G-1.
           ACQUISITIONS - ITEMIZE IN DETAIL          100% ORIGINAL COST                          DISPOSALS - ITEMIZE IN DETAIL     YEAR ACQUIRED 100% ORIGINAL COST

SCHEDULE  H                                           REAL ESTATE IMPROVEMENTS

During the past calendar year, did your business make improvements and/or other additions to real property owned by your business?  If yes, attach separate 
Schedule H-1 with information on such improvements.                                                           YES              NO
 
SCHEDULE  I                                 BILLBOARDS - OUTDOOR ADVERTISING STRUCTURES

Does your business own any billboards, or outdoor advertising structures?
If yes, attach separate Schedule I-1 with requested information.                                              YES              NO
 
SCHEDULE  J                                                     LEASED EQUIPMENT

Does your business lease equipment to others?
If yes, attach separate Schedule J-1 with requested information.                                              YES              NO
 
                                                                AFFIRMATION
        LISTING MUST BE SIGNED BY A LEGALLY AUTHORIZED PERSON - Please check the capacity in which you are signing the affirmation.
For Individual Taxpayers:          Taxpayer             Guardian              Authorized Agent               Other person having knowledge of and charged
                                                                                                       with the care of the person and property of the taxpayer.
For Corporations, Partnerships, Limited Liability Companies, Unincorporated Associations:
        Principal Officer of the Taxpayer      Full-time employee of the taxpayer who has been officially empowered by a principal officer to list
            Title ________________________          the property and sign the affirmation.  Title ____________________________
        Authorized agent.  If this capacity is selected, I certify that I have NCDOR Form AV-59 on file for this taxpayer:                 Yes              No 
 Under penalties prescribed by law, I affirm that to the best of my knowledge and belief, this listing, including any accompanying statements, inventories, schedules, 
 and any other information, is true and complete.  (If this is signed by an individual other than the taxpayer, they affirm that they are familiar with the extent and true 
 value of all of the taxpayer’s property subject to taxation in this county and that their affirmation is based on all the information of which they have any knowledge.)

 Signature                                                              Date                     Authorized Agent Address

 Telephone Number                                                                    Fax Number  Email Address
Any individual who willfully makes and subscribes an abstract listing required by Subchapter II of Chapter 105 of the North Carolina General Statutes, 
which they do not believe to be true and correct as to every material matter, shall be guilty of a Class 2 misdemeanor.  (Punishable by imprisonment 
up to 60 days.)



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                 INSTRUCTIONS – Listings due By January 31.                                      For example, a manufacturer of dish washers purchased a metal folding machine in 
                                                                                                 October 2020 for $10,000.  The sales tax was $200, shipping charges were $200, and 
Commonly Asked Questions                                                                         installation costs were $200.  The total cost that the manufacturer should report is 
                                                                                                 $10,600, if there were no other costs incurred.  The $10,600 should be added in group 
Who must file a listing, and what do I list?                                                     (1) to the 2020 current year’s cost column as an addition.
Any individual(s)  or business(es)  owning or possessing  personal  property used                                     Group (2) Construction in Progress (CIP)
or    connected  with  a  business  or  other  income  producing  purpose  on  January  1.  
Temporary absence of personal property from the place at which it is normally taxable            CIP  is  business  personal  property  which  is  under  construction  on  January  1.   The 
shall not affect this rule.  For example, a lawn tractor used for personal use, to mow the       accountant will typically not capitalize the assets under construction until all of the costs 
lawn at your home is not listed.  However, a lawn tractor used as part of a landscaping          associated with the asset are known.  In the interim period, the accountant will typically 
business in this county must be listed if the lawn tractor is normally in this county, even      maintain the costs of the asset in a CIP account.  The total of this account represents 
if it happens to be in another state or county on January 1.                                     investment in personal property, and is to be listed with the other capital assets of the 
                                                                                                 business during the listing period.  List in detail.  If you have no CIP, write “none”.
NCGS §105-308 reads that ..”any person whose duty it is to list any property who 
willfully fails or refuses to list the same within the time prescribed by law shall be guilty                         Group (3) Office Furniture & Fixtures
of a Class 2 misdemeanor.  The failure to list shall be prima facie evidence that the 
failure was willful.”  A class 2 misdemeanor is punishable by imprisonment of up to              This group is for reporting the costs of all furniture & fixtures and small office machines 
60 days.                                                                                         used  in  the  business  operation.    This  includes,  but  is  not  limited  to,  file  cabinets, 
                                                                                                 desks, chairs, adding machines, curtains, blinds, ceiling fans, window air conditioners, 
When and where to list?                                                                          telephones, intercom systems, and burglar alarm systems.
Listings  are due  on  or  before January  31.   They  must  be  filed  with  the  County                             Group (4) Computer Equipment
Tax  Department.  DO  NOT  FILE  THIS  FORM  WITH  THE  NORTH  CAROLINA 
DEPARTMENT OF REVENUE. This form will not be accepted by the NC Department                       This group is for reporting the costs of non-production computers & peripherals.  This 
of Revenue.                                                                                      includes,  but  is  not  limited  to,  personal  computers,  midrange,  or  mainframes,  as 
A list of county tax office addresses can be found at the NC Department of Revenue’s             well as the monitors, printers, scanners, magnetic storage devices, cables, & other 
Website. https://www.ncdor.gov/documents/north-carolina-county-assessors-list                    peripherals associated with those computers. This category also includes software 
                                                                                                 that  is  capitalized  and  purchased  from  an  unrelated  business  entity.   Note:  The 
As required by state law, late listings may result in a discovery with a penalty.  An            development cost of software or any modification cost to software, whether done 
extension of time to list may be obtained by sending a written request showing “good             internally by the taxpayer or externally by a third party to meet the customer’s 
cause” to the County Assessor by January 31.                                                     specified needs is excluded and should not be reported.  This does not include 
                                                                                                 high tech equipment such as proprietary computerized point of sale equipment or high 
How do I list? --  Three important rules:                                                        tech medical equipment, or computer controlled equipment, or the high-tech computer 
                                                                                                 components that control the equipment.  This type of equipment would be included in 
(1) Read these INSTRUCTIONS for each schedule or group. Contact your county tax                  Group (1) or “other”.
office if you need additional clarification.                                                                 Group (5) Improvements to Leased Property
(2) If a Schedule or Group does not apply to you, indicate so on the listing form, DO 
NOT LEAVE A SECTION BLANK, DO NOT WRITE “SAME AS LAST YEAR”.  A listing                          This group includes improvements made by or for the business to real property leased 
form may be rejected for these reasons and could result in late listing penalties.               or used by the business. The improvements may or may not be intended to remain 
(3) Listings must be filed based on the tax district where the property is physically            in place at the end of the lease, but they must still be listed by the business unless it 
located.  If  you  have  received  multiple  listing  forms,  each  form  must  be  completed    has been determined that the improvements will be appraised as real property by the 
separately.                                                                                      county for this tax year. Contact the appropriate county to determine if you question 
INFORMATION SECTION                                                                              whether these improvements will be appraised as real property for this tax year. If you 
                                                                                                 have made no improvements to leased property write “none”. Do not include in this 
Complete  all  sections  at  the  top  of  the  form,  whether  or  not  they  are  specifically group any Store Equipment- Group (1) or Office Furniture and Fixtures-Group (3).
addressed in these INSTRUCTIONS.  Attach additional sheets if necessary.                                              Group (6) Expensed Items
  
(1) Other N.C. Counties where personal property is located:  If your business has                This group is for reporting any assets which would typically be capitalized, but due to 
property normally located in other counties, list those counties here.                           the business’ capitalization threshold, they have been expensed.  (If you are able to 
(2) Contact person for audit:  In case the county tax office needs additional information,       provide the county tax office with a detailed list of costs and a description of the assets 
or to verify the information listed, list the person to be contacted here.                       in the Expensed Items category, please do so.)  Section 179 expensed items should 
(3)  Physical  address:    Please  note  here  the  location  of  the  property.    The  actual  be included in the appropriate group (1) through (4).  Fill in the blank which asks for 
physical location may be different from the mailing address.  Post Office Boxes are              your business’ “Capitalization Threshold.”  If you have no expensed items write “none”.
not acceptable.
(4) Principal Business in this County:  What does the listed business do? For example:                                Group (7) Supplies
Tobacco Farmer, Manufacture electrical appliances, Laundromat, Restaurant. The SIC 
or NAICS code may help describe this information, if you do not know the    SIC or               Almost  all  businesses  have  supplies.    These  include  normal  business  operating 
NAICS code, please write “unknown”.                                                              supplies.  List the cost on hand as of January 1.  Remember, the temporary absence of 
(5) Complete other requested business information. Make any address changes.                     property on January 1 does not mean it should not be listed if that property is normally 
(6) If out of business:  If the business we have sent this form to has closed, complete          present.  Supplies that are immediately consumed in the manufacturing process or 
this section and attach any additional information regarding the sale of the property.           that become a part of the property being sold, such as packaging materials, or raw 
Schedule A                                                                                       materials,  for  a  manufacturer,  do  not  have  to  be  listed.    Even  though  inventory  is 
                                                                                                 exempt, supplies are not.  Even if a business carries supplies in an inventory account, 
The year acquired column:  The rows which begin “2020” are the rows in which you                 they remain taxable.
report property acquired during the calendar year 2020.  Other years follow the same                                  Other Schedule A Property
format.
Schedule A is divided into seven (7) groups. Each is addressed below.  Some counties             This category should only be used if instructed by authorized county personnel.
may have the column “Prior Years Cost” pre-printed.  This column should contain the              SCHEDULE B  VEHICULAR EQUIPMENT - ATTACH ADDITIONAL SCHEDULES 
cost information from last year’s listing.  If it does not, please complete this column,         IF NECESSARY
referring back to your last year’s listing.  List under “Current Year’s Cost” the 100% 
cost of all depreciable personal property in your possession on January 1.  Include              Motor Vehicles registered with  the North Carolina Division  of Motor Vehicles 
all fully depreciated assets as well.  Round amounts to the nearest dollar.  Use the             as of January 1, do not have to be listed, with the exception of Multi-Year or 
“Additions” and “Deletions” column to explain changes from “Prior Yr. Cost” to “Current          Permanently Registered Trailers, Special Bodies on Vehicles, and International 
Yr. Cost”.  The “Prior Year’s Cost” plus “Additions” minus “Deletions” should equal              Registration  Plan  (IRP)  Plated  Vehicles.  Please answer the  questions  on  the 
“Current Years Cost” If there are any additions and/or deletions, please note those              form to determine if you should complete and attach separate schedules B-1 for 
under schedule G, Acquisitions and Disposals Detail. If the deletion is a transferred or         certain other vehicles, B-2 for Watercraft or Watercraft engines, B-3 for Mobile 
paid out lease, please note this, and to whom the property was transferred.                      Homes or Mobile Offices, or B-4 for Aircraft.
NOTE:  If you purchased an existing business and its assets since January 1, 2020,               SCHEDULE C PROPERTY IN YOUR POSSESSION, BUT OWNED BY OTHERS
do not complete this listing form without first contacting the county tax office for further 
instructions.                                                                                    If  on  January  1,  you  have  in  your  possession  any  business  machines,  machinery, 
COST - Note that the cost information you provide must include all costs associated              furniture,  vending  equipment,  game  machines,  postage  meters,  or          any other 
with the acquisition as well as the costs associated with bringing that property into            equipment  which is loaned,  leased, or otherwise  held and not owned  by you, a 
operation.    These  costs  may  include,  but  are  not  limited  to  invoice  cost,  trade-in  complete description and ownership of the property should be reported in this section.  
allowances,  freight,  installation  costs,  sales  tax,  expensed  costs,  and  construction    This information is for office use only.  Assessments will be made to the owner/lessor.  
period interest.                                                                                 If you have already filed the January 15th report required by §105-315, so indicate.  
                                                                                                 If you have none, write “none” in this section.  If property is held by a lessee under a 
The cost figures reported should be historical cost, that is the original cost of an item        “capital lease” where there is a conditional sales contract, or if title to the property will 
when first purchased, even if it was first purchased by someone other than the current           transfer at the end of the lease due to a nominal “purchase upon termination” fee, then 
owner.  For example, you, the current owner, may have purchased equipment in 2020                the lessee is responsible for listing under the appropriate group. 
for $100, but the individual you purchased the equipment from acquired the equipment 
in 2015 for $1000.  You, the current owner, should report the property as acquired in            SCHEDULE D, E, F, G, AND H, please answer the questions provided on the form to 
2015 for $1000.                                                                                  determine if you need to complete and attach separate schedules E-1, G-1, or H-1 to 
                                                                                                 the main business personal property listing form.
Property should be reported at its actual historical installed cost IF at the retail level of 
trade.  For example, a manufacturer of computers can make a certain model for $1000              AFFIRMATION
total cost.  It is typically available to any retail customer for $2000.  If the manufacturer 
uses the model for business purposes, he should report the computer at it’s cost at the          If the form is not signed by an authorized person, it will be rejected and could be 
retail level of trade, which is $2000, not the $1000 it actually cost the manufacturer.          subject to penalties.  This section describes who may sign the listing form.
Leasing companies must list property they lease at the retail trade level, even if their 
actual cost is at the manufacturer or wholesaler level of trade.                                 Listings submitted by mail shall be deemed to be filed as of the date shown on the 
                                                                                                 postmark affixed by the U.S. Postal Service.  Any other indication of the date mailed 
                 Group (1) MACHINERY & EQUIPMENT                                                 (such as your own postage meter) is not considered and the listing shall be deemed to 
                                                                                                 be filed when received in the office of the tax assessor.
This is the group used for reporting the cost of all machinery and equipment.  This 
includes all store equipment, manufacturing equipment, production lines (hi-tech or              Any person who willfully attempts, or who willfully aids or abets any person to attempt, 
low-tech),  as  well  as  warehouse  and  packaging  equipment.    List  the  total  cost  by    in any manner to evade or defeat the taxes imposed under this Subchapter (of the 
year of acquisition, including fully depreciated assets that are still connected with the        Revenue Laws), whether by removal or concealment of property or otherwise, shall be 
business.                                                                                        guilty of a Class 2 misdemeanor. (Punishable by imprisonment up to 60 days)






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