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Please take a moment to fill out the boxes below. Required items are highlighted in yellow. Cost Seg ONE can perform a rough analysis using just the purchase price of the building, year built, type of building, and a copy of your current depreciation schedule. However, please note that the more information you are able to provide us, the more accurate our estimated cost savings and fee will be. We thank you for providing us with the opportunity to work with you and will be in contact soon.

A. OWNER INFORMATION

Name (Co or Individual):*

Contact Person:*

Address:*

City, State, Zip:*

Contact E-mail:*

Contact Phone:*

Owner's Marginal Tax Rates:*

Federal:

State:

* Indicate required fields.

B. CPA INFORMATION

Company Name:

CPA Name:

Address:

City, State, Zip:

CPA E-mail:

CPA Phone:

Timing (What is the tax deadline?):

C. PROPERTY MANAGEMENT COMPANY

Company Name:

Contact Name:

Phone Number:

D. PROJECT INFORMATION

Property Name:

Address:

City, State, Zip:

Property Type/Nature of Industry:

Is this a freestanding building or leasehold improvement?

Date acquired or placed in service:

Date Constructed:

Is this property involved in a 1031 exchange?

If so, what is the net tax basis of the property?

Are (were) there other basis adjustments based on changes in ownership? (Sec. 754, 1033 Exchange, etc. If yes, explain.:

Costs:

Land:

Building:

Land Improvements:

(if separately identified: parking, sidewalks, landscaping, etc.)

Furniture, Fixture & Equip.:

(if separately billed in contract)

Total Project Cost:

(total of items 1 through 4)

Physical Characteristics:

Property:

Gross Sq Ft of Building:

Nr and Description of Tenants:

Total Sq. of Land:

Nr and Type of Vacant Tenant Spaces:

Site/Land Improvements:

Bridges:

Perimeter Walls:

Monument Signs:

Pond/Water Feature:

Fencing/Gates:

Site Light Poles:

Retaining Walls:

Canopies/Gazebos:

Other:

Parking:

Number of Spaces:

Carports:

Tuck-Under:

Free Standing Structure:

Asphalt/Paved:

Subterranean:

Other:

Other Information:

Were any renovations done after the purchase of the building?

Do you know of any major improvements made by the prior owner?

Are (were) there any plans for demolition of walls or to the parts of the structure? If yes, please explain.

Was there furniture or equipment acquired with the property? i.e. patio, meeting room, gym, etc. If yes please list.

Are (were) there any environmental/remediation costs? Asbestos removal, Hazardous waste cleanup, etc. If yes, please explain.

E. BUILDING DOCUMENTATION

Is any of the original construction cost detail available?** (i.e. contractor payment application, schedule of values, AIA documents, invoices)	Yes No
For lookback studies, is a depreciation schedule available?**	Yes No
For current year acquisitions, is the closing or escrow statement available?**	Yes No
For new construction, approximately what date was a binding contract to construct the property signed? (Bonus Depreciation Eligibility)
Is there an appraisal report available for our review?**	Yes No
Is a full set of blue prints available for the original Building & Tenant Improvements?	Yes No
If a full set of prints is not available, what prints are available? (site, electrical, etc)

1031 Exchanges: If you need CS1 to estimate the "net tax basis" of the property, we will need the following information if available:
Are the escrow statements for the new property and for the property sold available?	Yes No
Is the Land/Building split available for the property(ies) acquired and sold in the exchange?	Yes No
Is a depreciation schedule(s) available for the property(ies) sold in the exchange?	Yes No

Leased Properties:
Is a current Rent Roll available?**	Yes No
Is a Rent Roll available for the date of acquisition? (Lookback Studies)	Yes No
Who owns Tenant improvements? Were allowances given to tenants?
Did a prior landlord give Tenant Allowances to any tenant?	Yes No
Is a tenant improvement cost detail available?	Yes No
**If documents are available you can also send via fax to 1(916)244-7204, email info at info@costsegone.com, or mail to Cost Seg ONE Consulting group LLC., 770 L Street, STE 950, Sacramento, CA. 95814

How did you learn of Cost Seg One Consulting Group LLC?

Referal Source:

Thank you for your request. We will contact you shortly with your Estimate of Savings and fee quote. Please print a copy of this form for your records.

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