(12) Where will mail reach the company. (13) State the city or town, street number and state where this company maintained any store, warehouse, factory or other place of business outside the State of New York.. (14) Any corporation taxable hereunder may omit from this report the segregation of assets on this page only by signing the following consent I AM AUTHORIZED by the Board of Directors of this corporation to consent and I do hereby consent that said corporation be taxed upon its entire net income at 41⁄2 per cent or upon its entire issued capital stock at one mill on the dollar, as provided by law. Do not sign consent unless taxable by the State of New York on entire income or entire issued capital stock. (Official title) TOTAL SEGREGATED ASSETS WHEREVER LOCATED (a) Average monthly value of bills and accounts receivable for personal property manufactured by it....$.. (b) Average monthly value of bills and accounts receivable for personal property sold by the corporation from merchandise owned by it at the time of acceptance of order but not manufactured by it.....$.. (c) Average monthly value of bills and accounts receivable for services performed, based on orders received at offices maintained by the corporation, excluding bills and accounts receivable on orders filled from a stock of merchandise or other property maintained by the corporation. . . . . . $. Average monthly value of all its real property wherever located (actual value) $... $.. ... $... .$. $... $. state (c) Average monthly value of bills and accounts receivable for services performed, based on orders received at offices maintained by the corporation within this state, excluding bills and accounts receivable arising from sales made from a stock of merchandise or other property at a place of business maintained by the corporations within this state.... Average monthly value of its real property within this State as detailed in this report (actual value)...$.. Average monthly value of its tangible personal property in New York State as detailed in this report (actual value) Total.... §Average total actual value of shares of stocks of other corporations owned by it and allocated to this State by rule below $.. $. NOT TO BE FILLED Real property and tangible personal property shall be taken as its actual value where located. § The value of share of stock of another corporation owned by a corporation liable hereunder shall for purposes of allocation of assets be appor tioned in and out of the State in accordance with the value of the physical property in and out of the State representing such share stock. NOTE. If the amount of the annual net income of any corporation taxable under this article as returned to the United States treasury department is changed or corrected by a commissioner of internal revenue or other officer of the United States, such corporation, within ten days after receipt of such notification of change or correction, shall make return under oath or affirmation to the Tax Commission of such changed or corrected net income upon which the tax is required to be paid to the United States. If the company has no real or tangible personal property in this State it should give the name of the city, town, or incorporated village where its principal financial concerns are transacted within the State in panel 1 at the right and the word "none" should be entered in panel 2. If the company's entire real and tangible personal property in this State is in one city, or in one town outside a city or incorporated village, the schedules below need not be made, but the name of the city or town, and of the county where located must be entered in panel 3. If the company has real or tangible personal property in an incorporated village (or villages) in this State the name of such village and the town and county where such village is located must be entered below, together with the value of such property. Incorporated village of In the town of County of Personal Real (If more space is needed add a paster) The values of real and tangible personal property in villages must be distributed to the proper TOWNS in the table below. Do not confuse the political subdivisions "incorporated village" and "town." Names of hamlets or postoffices other than incorporated villages are not wanted. AFFIDAVIT OF PRESIDENT, VICE-PRESIDENT, SECRETARY OR .A. D. 191..., personally ap peared before me, a Notary Public in and for the County of... of the above named company, who, being duly sworn according to law, did depose and say that the foregoing report is just, true and correct and that it includes a true statement of the annual net income of said company for the year. (Official title) Sworn to before me the day and year aforesaid. Notary Public FORM 3 IT PENALTY NOTICE Any corporation which fails to make any report required by this article shall be liable to a penalty of not more than five thousand dollars to be paid to the State to be collected in a civil action, at the instance of the Commission; and any officer of any such corporation who makes a fraudulent return or statement with intent to defeat or evade the payment of the taxes prescribed by this article shall be liable to a penalty of not more than one thousand dollars, to be recovered by the State. (Tax Law, § 216.) STATE TAX COMMISSION, Corporations Liable to Taxation Under Article IX-A of the Tax Law Should Not Make This Report. This report is not to be made before October 31, 1918. When completed mail to State Tax Department, Albany, N. Y., to arrive not later than December 15, 1918. (See penalty notice.) As .of the Company I make the following report of such Company for the year ending October 31, 1918, pursuant to the provisions of Section 192, Chapter 60 of Consolidated Laws: (1) The last preceding report made by this Company to the State of New York under the provisions of the above acts was for the year ending October 31, 191... (2) Organized 19...., under the laws of.... (3) This Company began business in the State of New York on |