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074 <br />rSCHEDULE D <br />SEPARATELY SCHEDULED PROPERTY <br />1. Does your business own any artwork, displays, statues, or other personal property that is separately <br />scheduled for insurance purposes? YES <br />Please describe the items and estimated value of items if applicable. <br />SCHEDULE E J FARM EQUIPMENT <br />0 <br />C <br />NO <br />3 <br />v <br />r <br />a <br />0 <br />Does your business own any tractors and /or other farm equipment? YES f NO Cost on Schedule A <br />It so, list and attach separate schedule. If listed by cost on Schedule A, indicate above but still include information on separate schedule. <br />SCHEDULE F <br />INTANGIBLE PERSONAL PROPERTY <br />Do you lease or rent real property from exempt owners, such as a church, local, state, or federal government, an airport authority, university, or other <br />exempt owner? YES ' NO If yes, include lease information below. Attach additional schedule if necessary. <br />NAME AND ADDRESS OF OWNER DESCRIPTION OF PROPERTY AND LEAS RM MONTHLY PAYMENT ACCT. # <br />SCHEDULE G I ACQUISITIONS AND DISPOSALS DETAIL <br />Acquisitions and disposals detail of machinery, equipment, furniture and fixtures and computer equipment, and leasehold improvements in the prior <br />year. If there is not enough room below, attach separate schedule. <br />1151 I x)N5 . ITEWIIZE IN DETAIL <br />70 /c <br />100% ORIGINAL COST <br />7/, 995 <br />DISPOSALS - ITEMIZE IN DETAIL <br />K Dour <br />YEAR ACQUIRED <br />/987 <br />100% ORIGINAL COS <br />949 <br />x L Sctcen <br />B[rckell <br />en /nsfi� / /ofian <br />Gala Ptinz`cr- <br />EA <br />144, $G / <br />7, / 7/ <br />!97 93 <br />/,X77 <br />/n oral! A -,?no/ 4a^ irssor <br />hrc �xco a r <br />1995 <br />2002 <br />53102 <br />/30 a4 � <br />423,4¢3 <br />4 /G, 42/ <br />SCHEDULE H REAL ESTATE IMPROVEMENTS <br />During the past calendar year, did your business make improvements and /or other additions to real property, owned by your business? If yes, attach <br />a separate schedule with information on such improvements. YES *NO <br />AFFIRMATION <br />LISTING FORM MUST BE SIGNED BY A LEGALLY AUTHORIZED PERSON - SEE INSTRUCTIONS <br />Under penalties prescribed by law, I hereby affirm that to the best of my knowledge and belief this listing, including any accompanying statements, inventories, <br />schedules, and other information, is true and complete. (If this is signed by an individual other than the taxpayer, he affirms that he is familiar with the extent and <br />true value of all the taxpayers property subject to taxation in this county and that his affirmation is based on all the information of which he has any knowledge.) <br />Listing MUST be gned by the taxpayer, a principal officer of the taxpayer or a FULL -TIME employee of the taxpayer who has been officially empowered by the <br />prineipal,gffi o IlaAe property. <br />Siena Date <br />Ass /. n/ro r <9l4 z---- -`/00 <br />Title Telephone Number <br />Preparer Other Than Taxpayer <br />Address <br />pcferna/,q�1rr� C� Wa /i'c S t , 0Q <br />Emai Address —� Fax Number <br />Telephone Number <br />Any individual who willfully makes and subscribes an abstract listing required by the Subchapter (of the Revenue Laws) which he does not <br />believe to be true and correct as to every material matter shall be guilty of a Class 2 Misdemeanor. (Punishable by imprisonment of up to 60 days). <br />