BOE-577-A

Source: https://www.boe.ca.gov/proptaxes/pdf/sample-boe577a.pdf

This page watermarked sample only. Contact Assessor for actual form.

BOE-577-A REV. 03 (07-25)

20 _____ AIRPORT OPERATIONS REPORT

TO OWNERS AND OPERATORS OF PRIVATE AND PUBLIC AIRPORTS: Section 5368 of the Revenue and Taxation Code requires this form to be completed and returned to the County Assessor upon request. Pursuant to this section, the County Assessor hereby requests information regarding the aircraft registration number, make, model and arrival and departure information of all aircraft utilizing your airport facilities for the calendar year. The requested information may be provided in electronic format.

COUNTY AIRPORT NAME CALENDAR YEAR

AIRCRAFT REGISTRATION AIRCRAFT TYPE AIRCRAFT IDENTIFICATION INDICATE IF ARRIVAL OR LOCAL TIME AND DATE NUMBER MAKE AND MODEL (FLIGHT NUMBER) DEPARTURE ONLYForm Actual for SAMPLE Assessor

CERTIFICATION

I certify (or declare) under penalty of the laws of the State of California that the foregoing, and all information herein, is true, correct, andcomplete toContactthe best of my knowledge and belief.

Additionally, if this form is submitted with an electronic signature, I also certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing, and all information herein, including any accompanying statements or materials, is true, correct, and complete to the best of the taxpayer's knowledge and belief.

SIGNATURE DATE t NAME TITLE

E-MAIL ADDRESS DAYTIME TELEPHONE ( ) THIS DOCUMENT IS SUBJECT TO PUBLIC INSPECTION