IDB/H&ED Form
REPORT OF PROPERTIES OWNED BY HEALTH AND EDUCATION, INDUSTRIAL DEVELOPMENT
AND SPORTS AUTHORITY BOARDS (Rev. 2008)

(Note: late fee due after October 1) Tennessee law requires businesses leasing property from certain public boards and authorities to annually report to the State Board of Equalization concerning the leased properties. IMPORTANT, PLEASE READ: To fill out the form, you must use the TAB key to move from field to field. After completing the form, hit the ENTER key or click on the Submit form to State Board button.

IDB Report Frequently Asked Questions

GENERAL INFORMATION
County:	Anderson Bedford Benton Bledsoe Blount Bradley Campbell Cannon Carroll Carter Cheatham Chester Claiborne Clay Cocke Coffee Crockett Cumberland Davidson Decatur Dekalb Dickson Dyer Fayette Fentress Franklin Gibson Giles Grainger Greene Grundy Hamblen Hamilton Hancock Hardeman Hardin Hawkins Haywood Henderson Henry Hickman Houston Humphreys Jackson Jefferson Johnson Knox Lake Lauderdale Lawrence Lewis Lincoln Loudon McMinn McNairy Macon Madison Marion Marshall Maury Meigs Monroe Montgomery Moore Morgan Obion Overton Perry Pickett Polk Putnam Rhea Roane Robertson Rutherford Scott Sequatchie Sevier Shelby Smith Stewart Sullivan Sumner Tipton Trousdale Unicoi Union Van Buren Warren Washington Wayne Weakley White Williamson Wilson
Year:	2004 2005 2006 2007 2008
Owner name:
Lessee name and address:
This property is owned in the name of (select one):	Industrial Development Board (T.C.A. §7-53-301) Health, Housing & Educational Facility Board (T.C.A. §48-101-307) Sports Authority Board (T.C.A. §7-67-108)
Has lessee name changed since last filing?:	YES NO
PERSON FILING THIS REPORT:
Name:
Title:
Address:
Phone:
E-mail:
1. PROPERTY LISTING
List all the real and personal property owned by the ID/H&ED Board which is leased or subleased by this lessee as of last January 1. List each property separately if it has a separate parcel or account in the assessor's records:
Project type code (see instructions) Property address or location State the city where the property is located  Assessor's id. no. A. B. C. D. E.
2. PROPERTY DETAIL
For each of the above properties, provide the following information:
EST. VALUE DATE1 TERM RENT PILOT/CITY PILOT/CO. DATE2 L/H TAX (if any) A. B. C. D. E.
	EST. VALUE: Good faith estimate of value DATE1: Lease date TERM: Lease term (mos./yrs.) RENT: Amount of stated rent per the lease PILOT/CITY: Annual payments in lieu of property taxes payable to or for the benefit of a city PILOT/COUNTY: Annual payments in lieu of property taxes to or for the benefit of a county DATE2: Date the property is scheduled to return to the regular tax rolls L/H TAX: If the assessor has recorded a positive value for the leasehold interest, state the amount of tax due.
A copy of this report must be filed with the county assessor of property by October 15. Has a copy of this report been filed with the county assessor?:	YES NO
This report must be completed and submitted to the State Board of Equalization annually before October 1. The report is late if postmarked after October 1. Late filed reports must be accompanied by a late fee of $50. The report may be submitted electronically through our web site at www.comptroller.state.tn.us. For questions, call or write the Board or visit our IDB Report Frequently Asked Questions.
	State Board of Equalization Ste. 1700, 505 Deaderick St. Nashville, TN 37243-0280 (615) 401-7883