Date
Date
Name/Address of Company
IRS*
Transportation/
Classifi-
# of
Acquired
Installed
from whom property was acquired
Purchase
Installation
Total Cost
cation
Property Description & Model ID #
Items
Mo./Day/Yr.
Mo./Day/Yr.
(Seller/Lessor & Lease ID#)
Price
Cost
of Acquisition
Page Total
*Property shall be treated as:
If it has a class life (in years) of:
5 year property . . . . . . . . . . . . . . . . . . . . . .more than 4 but less than 10
Grand Total
7 year property. . . . . . . . . . . . . . . . . . . . . . . 10 or more but less than 16