2014 P
P
D
– S
F
S
S
ERSONAL
ROPERTY
ECLARATION
HORT
ORM
UMMARY
HEET
Commercial and financial information is not open to public inspection
Assessment date October 1, 2014
Required return date November 3, 2014
List or Account #
Owner’s Name
DBA
Address
City/State/Zip
/
Street location of personal property
Phone / Fax
E-mail
Description of business:
Type of ownership: Corporation Partnership LLC Sole Proprietor Other-Describe
Type of business: Manufacturer Wholesale Service Profession Retail/Mercantile Tradesman Other
IRS Business Activity Code
Square footage
No. of Employees
A
’
#9 Motor Vehicles
SSESSOR
S
UNREGISTERED motor vehicles (e.g. campers, RV’s, snowmobiles, trailers, trucks, passenger cars, tractors, off-road construction
vehicles, etc.) including any vehicle garaged in Connecticut but registered in another state, or any such vehicle not registered at all. If you are a farmer
U
O
SE
NLY
eligible for the exemption under Sec. 12-91, list tractors in Code 17.
A
Year
Make
Model
Identification No.
Length
Weight
Purchase
Date
Value
SSESSMENTS
Code
Price
#9
#9
#9
#11 Horses And Ponies
Describe your horses and ponies. A $1,000 assessment exemption per animal will be applied. If you are a farmer, the
exemption may be 100% provided Form M-28 is filed with and approved by the Assessor.
Breed
Age
Registered
Sex
Quality:
Value
Breeding/Show/Pleasure/Racing
#11
#11
#11
#14 Mobile Manufactured Homes
if not currently assessed as real estate
Year
Make
Model
Identification No.
Length
Width
Bedrooms
Baths
Value
#14
Net Depreciated
Property Code and Description
Value
From page 2
#12 - Commercial Fishing Apparatus
All fishing apparatus exclusively used by a commercial fisherman in his business (e.g.,
#12
fishing poles, nets, lobster pots, fish finders, etc.). A $500 value exemption will be applied.
#16 - Furniture & Fixtures
Furniture, fixtures and equipment of all commercial, industrial, manufacturing, mercantile, trading
and all other businesses, occupation and professions. Examples: desks, chairs, tables, file cabinets, typewriters, calculators,
copy machines, telephones (including mobile telephones), telephone answering machines, facsimile machines, postage meters,
#16
cash registers, moveable air conditioners, partitions, shelving display racks, refrigerators, freezers, kitchen equipment, etc.
#17 - Farm Machinery
Farm machinery (e.g., tractors, harrows, bush hogs, hay bines, hay rakes, balers, corn choppers,
milking machines, milk tanks, coolers, chuck wagons, dozers, back hoes, hydroponic farm equipment, aquaculture equipment,
#17
etc.), used in the operation of a farm.
#18 - Farming Tools
Farm tools, (e.g., hoses, rakes, pitch forks, shovels, hoses, brooms, etc.).
#18
#19 - Mechanics Tools
Mechanics tools (e.g., wrenches, air hammers, jacks, sockets, etc.).
#19
#20 - Electronic Data Processing Equipment
Electronic data processing equipment (e.g., computers, printers, peripheral
computer equipment, and any computer based equipment acting as a computer as defined under Section 168 of the IRS Code
#20
of 1986, etc.). Bundled software is taxable and must be included.
#23 - Average Supplies
The average monthly quantity of supplies normally consumed in the course of business (e.g.,
stationery, post-it notes, toner, computer disks, computer paper, pens, pencils, rulers, staplers, paper clips, medical and dental
#23
supplies and maintenance supplies, etc.).
#24 – Other
All Other Goods, Chattels and Effects Any other taxable personal property not previously mentioned or which does
not appear to fit into any of the other categories. (e.g. video tapes, vending machines, pinball games, video games, signs,
#24
billboards, coffee makers, water coolers, leasehold improvements other than realty etc.).
Total Assessment – all codes #9 through #24
Subtotal >
#25 – Penalty for failure to file as required by statute – 25% of assessment
#25
-
Exemption
Check box adjacent to the exemption you are claiming:
I – Mechanic’s Tools - $500 value M – Commercial Fishing Apparatus - $500 value
I – Farming Tools - $500 value
I – Horses/ponies $1000 assessment per animal
All of the following exemptions require a separate application and/or certificate to be filed with the Assessor by the required return date
J – Water Pollution or Air Pollution control equipment – Connecticut DEP certificate required – provide copy
I – Farm Machinery $100,000 assessment - Exemption application M-28 required annually
G & H – Distressed Municipality/Enterprise Zone/Enterprise Corridor Zone - Exemption application M-55 required annually
Total Net Assessment
Assessor’s Final Assessment Total >
Page 3