Asset Retirement Initial Evaluation Request Form

Please fully complete the form below, and we’ll get back to you shortly.

Your Information
Date
Date Format: MM slash DD slash YYYY
Name*
Phone*
Email*
Address*
Street Address City State ZIP Code

Property Information
Name of Property*
Name of Entity*
Physical Property Address*
City*
State*
Zip Code*
Description of Property at Time of Purchase (e.g.: industrial, office, retail, apartment)*
Present Building Usage*
Square Feet*
Number of Floors*
Number of Buildings*
Purchase Date or Placed-In-Service Date (mm/dd/yyyy)
Total Purchase Price or Project Cost (including land cost, if any)
Amount of Purchase Price or Project Cost Allocated to Land

Subsequent Building Improvment Costs
1.
Following info is year 1 improvements.
Year
Amount
Description
2.
Following info is year 2 improvements.
Year
Amount
Description
3.
Following info is year 3 improvements.
Year
Amount
Description
4.
Following info is year 4 improvements.
Year
Amount
Description
5.
Following info is year 5 improvements.
Year
Amount
Description

Documents
The following documents are required:

• Federal Tax Depreciation Schedule
(If the property has been placed in service and a Federal Tax Return has been filed, the Federal Depreciation Schedule is required to complete the initial evaluation.)
• Closing Statement -- If Available
• Recent Appraisal (Cost Information) -- If Available

Use the inputs below to upload the necessary files.
File
File
File

Other Available Documents
Are Any of the Following Documents Available? (Please check all that apply)
- AIA Payment Applications
- Project Budget Summary
- Change Orders
- Building Blueprints
- Building Blueprints
- Photos of New Assets
- Photos of Removed Assets
- Photos of Removed Assets
Additional Notes
Enter Any Additional Notes
M&E Representative
Name of Your M&E Representative