Benefits Estimate Request
Service Provider
*
Product
*
Date of Request
-
Month
-
Day
Year
If you are already working with a preferred OnPoint Specialist, let us know
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Jackson Holdsworth
Randy Cox
Rick Vandaveer
Susie Pulido
William Hein
Please indicate which Cost Segregation Specialist you prefer to work with
Submitter's Name
*
Submitter's Email:
*
example@example.com
Study Type
*
Cost Segregation
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Property Owner Information
Property Owner Name:
*
Property Owner Address:
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Owner's expected federal income tax rate:
Contact Name:
*
Contact Title
Contact Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Contact Email:
*
example@example.com
Preferred method of contact for the delivery of the information
Phone
Email
Text
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Property Information
Property Address:
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
County: (if known)
Project ID
Type of Property:
*
apartment
auto dealership
casino
dental office building
distribution center
funeral home
golf course/range
grocery store
healthcare facility
hotel/motel
industrial building
manufacturing facility
medical center
medical office building
office building
residential rental - short term
residential rental - long term
resort
restaurant
fast food restaurant
retail mall
stand-alone retail store
retail strip center
self storage facility
shopping mall
sports facility
warehouse
other use
If other use, please describe
Reason for Cost Segregation Study. Property was:
*
newly constructed
purchased
improved
purchased + improvements
Purchase or Occupancy Date:
*
-
Month
-
Day
Year
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Total Cost Paid:
*
Declared Land Value - If you know the amount, please enter that amount provided by the property owner or their tax expert/CPA.
1031 Exchange or other government incentive funds used, if any:
Total amount spent after acquisition for improvements
Net Amount Asset Value to be used for depreciation purposes
Was the building "in service" prior to the additional construction expenditures?
Yes
No
Don't Know
If known, please list amount and date of after-acquisition expenditure(s)
Has this property been reported on this owner's previous year(s) tax filing?
*
Yes
No
Don’t know
If a previous year's tax filing included this property, please provide the latest depreciation schedule filed with the IRS.
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Property Photos and Drawings & Misc. Information
Suggested: Exterior, interior, Drawings
Is parking Included With the property?
Yes
No
Don't Know
If known, parking surface:
Concrete
Blacktop
Concrete & Blacktop
Gravel, sand, dirt, or other
Any additional relevant misc. info:
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