LARRY W. WARD COUNTY OF RIVERSIDE ASSESSOR-COUNTY CLERK-RECORDER BUSINESS PERSONAL PROPERTY DIVISION Telephone (951) 955-6210 Fax (951) 955-8535 Mail Address: P.O. Box 1240 Riverside, CA 92502-1240 E-mail Address: bpphd@co.riveriside.ca.us Websites: www.riversideacr.com www.riversidetaxinfo.com REQUEST FORM/STATEMENT OF CHANGE FORM (PLEASE PRINT) Owner Name (as shown on tax bill) _______________________________________________________ Assessment No. ___________________________ Aircraft N# ___________Boat CF# __________ Signature ____________________________ Date _____________ Tel._______________________ Fill out the applicable section(s) below. REQUEST FOR PROPERTY STATEMENT (Form 571-L or 571-F) Tax year(s) requested _______________________________________ For new assessments only (no existing assessment no.): 1. Owner name(s)_________________________________________________________________________ 2. D.B.A.________________________________________________________________________________ 3. Mail name (c/o or attn, if applicable) _________________________________________________________ 4. Mail address (street or P.O. box/city/state/ZIP) _________________________________________________ 5. Location of property (street/city/ZIP) _________________________________________________________ 6. Type of business Retail Wholesale Manufacturing Service/Prof. 7. Business activity (describe) ________________________________________________________________ ________________________________________________________________________________________ _________________________________________________________________________________ REQUEST FOR CHANGE OF MAIL ADDRESS New mail address (street or P.O. box/city/state/ZIP) _________________________________________________________________________________________ _________________________________________________________________________________________ __________________________________________________________________________________ STATEMENT OF CHANGE IN PROPERTY STATUS Sold: Business Aircraft Boat Date sold ____________________________________________ New owner’s name _________________________________________________________________________ New owner’s mail address ___________________________________________________________________ _________________________________________________________________________________________ Moved: Business Aircraft Boat Date moved __________________________________________ New location ______________________________________________________________________________ Permanently Closed Business: Date closed ___________________________________________ Disposition of assets Sold Abandoned Other (describe) ___________________________________ __________________________________________________________________________________________ ACR 205P-AS3BP0 (Rev. 09/2006) Available in Alternate Formats American LegalNet, Inc. www.FormsWorkflow.com